Restoring the interproximal zone using the proximal adaptation technique--part 1.
The concepts of the preadhesive era sanctioned the mechanical removal of healthy, sound tooth structure to perform restorative procedures. This mechanical systematic approach to enhance the retention of the restoration by modifying the cavity form included 6 principles: outline form, resistance form, retention form, convenience form, removal of caries, and finish of the enamel walls, margins, and toilet of the cavity. This philosophy was challenged during the adhesive era with a biologic approach. Dramatic changes in the understanding and control of caries, with a reduction in the incidence and severity of caries, and even the process of detecting decay with chemical agents, has forced clinicians to re-think and modify their preparation designs and principles. Some of the mechanical principles are still being used with current adhesive dentistry and clinicians wonder why they continue to have microleakage, recurrent decay, and sensitivity. The effect of this misdirection could be one of the reasons for the relatively short longevity for some adhesively placed restorations. These adhesive design concepts require the clinician to modify nonadhesive techniques when considering preparation design, restorative material selection, adhesive protocol, and placement procedures and techniques. Although the original design principles are outdated by today's standards they are still applicable in the modern dental practice by simply modifying the 6 basic principles. The clinical objectives in the era of minimally invasive adhesive dentistry has become prevention, preservation, and conservation.
Terry
Douglas A
DA
University of Texas Health Science Center Dental Branch, Houston, Texas, USA.
D000269:Adhesives / Q000627:therapeutic use; D003731:Dental Caries / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000379:methods*; D018772:Dental Marginal Adaptation; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention / Q000379:methods; D003793:Dental Restoration, Permanent / Q000379:methods*; D006801:Humans; D007284:Inlays
D000269:Adhesives