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How to avoid sensitivity after resin filling, listen to what the "old dentist" said

2020-12-18

X-ray examination of the china  dental laboratory before the operation, the bottom of the bottom; ensure the closeness of the filling body and the tooth defect; operating specifications, such as the acid etching time, the amount of filling each time during filling, to ensure that the filling is fully cured.

The tooth preparation should be lightly ground intermittently, the adhesive should not be too thick, the correct indication should be selected, the acid etching time should not be too long, and the c factor should be reduced. There are too many reasons.

This is more headache, usually zinc oxide first appeases.

Before filling, it is necessary to judge the condition of the pulp and whether there is congestion. Deep cavities must be bottomed. Etching agent I use self-etching, all acid also irritates dental pulp. Make a short slope when preparing the hole shape to avoid micro leakage. If the patient accepts, try to choose a good resin. Don't be too reckless when adjusting the occlusion. I find that sometimes the sensitivity is because we wear away the enamel of the non-filling part when adjusting the occlusion, and the essence is exposed, so the patient will be sensitive. . . Although I am very careful, sometimes patients are still sensitive after surgery. Welcome everyone to share their experience and make progress together!

Correctly choose full acid or self-acid, and control the full acid time to avoid the acid etching depth greater than the bonding depth. Fluid resin lining holes and resin spherical filling control the influence of C factor.

Prepare the hole carefully. If the hole is deep, it must be the bottom, and the acid must be washed away.

First of all, to remove the decay, pay attention to the intermittent water mist and do not pressurize it. Secondly choose the caries display agent to use. Third, layer filling, using low-heat and high-efficiency light curing lamps, and another, self-acid and full-acid choice, and finally, every step must strictly implement the standards and pay attention to details.

After the acid etching, the dentin is too dry and micro-leakage may occur.

Using calcium hydroxide as a base, the effect is not bad.

1. Bring water to rot at low speed

2. Correctly master the use of adhesives

3. Full acid etching adhesive must be wet bonded

4. Self-etching adhesive and fluid base for deep cavity

5. Adhesive coating time, residence time and thickness control, etc.

※The local anaesthesia will decay, the high-speed mobile phone will cool down in cold water, and the final soft dentin will be slowly drilled. The process is carried out strictly in accordance with the full acid etching and wet bonding, and the 3M fluid resin cavity is used.

※Middle and deep cavities should be bottomed, calcium hydroxide preparation should be placed near the pulp, and the cavities must not be too dry.

※The filling process is as standard as possible to reduce unnecessary stimulation.

※Wet bonding.

※Control the acid etching time to avoid excessive acid etching. Apply the adhesive several times, let it stand and blow gently. Make the binder completely penetrate the collagen fiber network.

※Layered curing, lengthen the light curing time and times, and do a good job of bottoming.

※Strictly keep moisture away.

※Twenty seconds after the adhesive is applied, light cure again. In addition, the enamel must have a hole bevel.

※There are too many sensitive reasons after resin filling, and it is not clear to judge the degree of caries. Deep caries need to be comforted or filled directly. There is also the use of etching agents. The most commonly used full-etching agents on the market are enamel etchants, which is 37% phosphoric acid. Many doctors also apply dentin. Incorrect use method increases the chance of postoperative sensitivity. Self-etching etchants do not have this problem. In the case of full acid etching, pay attention to the control of the etching time, generally no more than 20 seconds. Please refer to the manual of each material for details and use strictly according to the instructions. Also, during the filling process, if the adhesive is too thick or not applied enough, or there are bubbles between the resin and the resin, it is easy to cause micro leakage and cause postoperative sensitivity. (Personal humble opinion, for reference only)

※Polishing is very important to avoid excessively high interference tips! Highly polished!

※The selection of acid etching adhesive should be operated strictly in accordance with the instructions to fully understand the performance of the material. When filling the resin, pay attention to the tightness of the combination of the resin and the tooth body and the edge, and then use the sealant to strengthen the sealing of the edge.

※Remove humus under anesthesia, pay attention to the amount of water mist not to be too low to avoid irritating the dental pulp, the speed not to be too high, and to ensure the quality of the mobile phone and bur, if necessary, use an excavator. Routine disinfection, drying, moisture-proofing and treatment of the cavity with a desensitizer, and then using a Decal backing, pay attention to cover all the dentin part and only keep the enamel part. Then it is temporarily sealed for one week. After asymptomatic, the temporary sealing is removed and the conventional resin is filled with light. The patient's rest room will stay for one hour to end the treatment process! Just for reference, I hope to advise.

※The sidewall filling method has a good effect of filling the sidewall axis angle layer by layer.

※I think there are three reasons. The first is that the etching agent is not rinsed off when using total acid. The second is that excessive drying causes air to enter the dentin tubules. The third is that the resin filling is not tight enough.

※I apply a layer of adhesive after resin filling.

※Intermittent abrasion, control of the amount of water, the application of local anesthetics when necessary, the desensitization treatment before the resin filling, and the rational use of the base material can all reduce the sensitive symptoms after the filling.

※Deep caries base, choose the appropriate adhesive, the adhesive coating time is more than 20 seconds to fully penetrate, and the thickness is a layer of paper to avoid micro-leakage. The resin filling is formed separately for each tooth tip to avoid air bubbles. It is necessary to use a desensitizer.

※To clean the rot! When the hole is relatively deep, keep moisture tight! The glass sub-complex is at the bottom! Kuraray self-acid binder! Pressurized tight cross filling! It is best to light the binder and dry it!

※I think the most important thing is that the acid phagocytosis time should be accurate to the second, and the acid etching time should be enough to rinse. 2. The application of the adhesive should be repeated, and it should be applied to every place, enough time to apply. 3 Use special resin filling equipment to prevent the edge of the sticky knife from leaking.