Investigating the Role of Marginal Adaptation of Indirect Restorations as a Plaque Retentive Factor and Its Influence on the Attachment Level // Изследване ролята на маргиналната адаптация на индиректни възстановявания като плакретентивен фактор и влиянието и върху нивото на прикрепване

Abstract

Carious lesions involving both the occlusal and proximal sides of distal teeth are a common problem in dental practice. These cases are further complicated if the defect is subgingival, below the enamel-cement junction (ECJ) level. The clinical survival of restorations largely depends on the quality and precision of their marginal adaptation. Poor marginal adaptation can lead to microleakage and plaque retention, which can result in the formation of a plaque retentive factor in the area. This inevitably leads to negative consequences on the periodontium of the corresponding tooth. Regarding the treatment of class II defects, direct composite obturations and indirect ceramic restorations are usually taken into consideration. Regardless of the constant innovations in composite materials, the conversion of monomers into polymer chains is always associated with polymerization shrinkage. Polymerization shrinkage can lead to poor marginal adaptation of composite obturations and failure of the adhesive bond. In indirect ceramic restorations, polymerization shrinkage is limited only to the thin layer of cement needed for cementation. They are made in a dental laboratory, providing better contour control, adaptation and polishing. CAD/CAM technologies facilitate the design and fabrication of ceramic restorations and, in this way, reduce the risk of human error. It is up to the clinician to choose the appropriate material, technique and dental cement for the indirect restoration.

Carious lesions involving both the occlusal and proximal sides of distal teeth are a common problem in dental practice. These cases are further complicated if the defect is subgingival, below the enamel-cement junction (ECJ) level. The clinical survival of restorations largely depends on the quality and precision of their marginal adaptation. Poor marginal adaptation can lead to microleakage and plaque retention, which can result in the formation of a plaque retentive factor in the area. This inevitably leads to negative consequences on the periodontium of the corresponding tooth. Regarding the treatment of class II defects, direct composite obturations and indirect ceramic restorations are usually taken into consideration. Regardless of the constant innovations in composite materials, the conversion of monomers into polymer chains is always associated with polymerization shrinkage. Polymerization shrinkage can lead to poor marginal adaptation of composite obturations and failure of the adhesive bond. In indirect ceramic restorations, polymerization shrinkage is limited only to the thin layer of cement needed for cementation. They are made in a dental laboratory, providing better contour control, adaptation and polishing. CAD/CAM technologies facilitate the design and fabrication of ceramic restorations and, in this way, reduce the risk of human error. It is up to the clinician to choose the appropriate material, technique and dental cement for the indirect restoration.