Restoring Primary PosteriorTeeth With A Compomer

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Restoring Primary PosteriorTeeth With A Compomer

• Using L.D. Caulks Dyract

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Dyract AP

• Dyract AP (Advanced Performance) is a compomer
  manufactured by Caulk.
• Compomers are polyacid-modified hydrophilic resin
  composites, containing glass particles, which are
  somewhat dissolved as oral fluids activate the
  acid in the biomaterial. As a result fluoride is
  released, creating cariostatic potential for the
  restoration.

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Dyract AP

• Dyract is indicated for use in the conservative
  restoration of primary teeth. It is not
  recommended for use in permanent teeth as its
  long term service characterisitics (lower
  strength and higher wear rate) are less desirable
  than an amalgam or a resin-based composite such
  as Herculite.

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conventional glass-ionomer
conventional resin-composite
polyacid-modified resin composite
resin-modified glass Ionomer
Ketac-Fil
Dyract
Herculite
Fuji II LC
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Technique

• A conservative, bio-mechanically sound cavity
  preparation is completed in the primary tooth.
• If a Class II, the preparation should be
  identical to a Class II amalgam preparation.
• If a Class I, the preparation should not be
  extended for prevention, rather any fissures
  remaining after extending sufficiently to
  eradicate the carious lesion should be
  conditioned and sealed with a fissure sealant.

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Dyract Technique

• The cavity preparation is then etched with 37
  orthophosphoric acid for 20 seconds, thoroughly
  washed for 20 seconds, and then air dried.
• The manufacturer indicates that enamel
  conditioning is not an absolute requirement when
  restoring primary teeth, and the Prime and Bond
  can be placed without conditioning.
• However, Caulk does acknowledge that etching does
  improve marginal integrity, and it is therefore
  recommended by Pediatric Dentistry.

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Dyract Technique

• Caulks Prime and Bond is placed with a clean
  disposable brush, thoroughly wetting all surface
  of the preparation.
• The surfaces should remain wet for 20 seconds.

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Dyract Technique

• Gently air dry for 5 seconds
• The surface should have a uniform glossy
  appearance if not reapply Prime and Bond.
• Light cure for 10 seconds.
• When a matrix is being utilized, Prime and Bond
  should be applied and cured before the matrix
  band is placed.

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Dyract Technique

• Dyract is supplied in compules with fourteen
  different shades. The shades employed with
  primary teeth are the two lightest XL and B1.

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Dyract Technique

• Dyract is dispensed in a compule and applied
  using a composite gun.

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Dyract Technique

• Apply the Dyract biomaterial in increments no
  thicker than 3 mm light curing each increment
  for 40 seconds.
• Restore the tooth to its normal contour and
  function.

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Dyract Technique

• Finish with an appropriate composite finishing
  and polishing system.
• 12 fluted carbide burs can be used to finish and
  contour the restoration
• 7406 (egg) , for the occlusal
• 7902 (needle), for the proximal
• 7802 (bullet), for fine grooves on the occlusal
  
• Caulks Enhance polishing point can be used to
  polish the restoration. ESPE 3Ms Softflex and
  Caulks Prisma Gloss can be also used.
  Alternatively, the 3300 (green) and the 3301
  (gray) diacomp points can be employed.

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Herculite

• Herculite is a conventional resin-composite. As
  such, it has greater wear resistance and strength
  than a polyacid-modified resin composite such as
  Dyract. Therefore, it has considerable greater
  longevity.
• When completing Class I restorations (sometimes
  referred to as Preventive Resin
  Restorations-PRRs) on young permanent teeth, it
  is the material of choicenot Dyract for the
  reasons identified above.
• Manufacturers instructions for using Herculite
  should be followed. However, they are essentially
  the same as those for Dyract.
• Please note that the Division of Pediatric
  Dentistry requires that conventional Class 1
  preparations be employed in such instances,
  always completed in sound dentin, and extended
  such that the dentino-enamel junction of the
  preparation can be visualized throughout
  ensuring no caries remains at the d.e.j. This is
  to be distinguished from what some advocate, that
  is, that only enamel need be removed, if thought
  that only enamel is involved and that a
  conventional preparation with a flat pulpal floor
  completed in sound dentin is not required.