Zahnkeile: Ein wesentliches Werkzeug in der restaurativen Zahnmedizin

Obwohl klein, Zahnkeile spielen eine unersetzliche Rolle in der restaurativen Zahnheilkunde. Sie werden hauptsächlich zur Zahntrennung verwendet, Stabilisierungsmatrixbänder und Gestaltung der Ränder der Restaurationen. Abhängig vom Material und Design, Die klinische Leistung und Verwendung von Keilen variieren. In diesem Artikel, Wir werden die Arten von systematisch analysieren Zahnkeile, ihre materiellen Eigenschaften, ihre Hauptfunktionen und ihre Anwendung bei der Füllung und Wiederherstellung.

1. Arten von Zahnkeilen und Materialeigenschaften

Plastik -Zahnkeile

Material: Oft aus medizinischem Polypropylen hergestellt (Pp), flexibel.

Vorteile:

• Mäßige Elastizität verringert den Druck auf Zahnfleisch.
• Kann bei hohen Temperaturen sterilisiert werden und ist für die Wiederverwendung geeignet.

Nachteile:

• Begrenzte Unterstützung, nicht für Fälle mit geeignet tiefe Karies oder enge Lücken.

Beispielanzeige:

• Zahnwächter (GD-5675): mit Loch mit rblade
  Drei Größe: Groß/mittel/klein
  
• Anpassungsfähige Keile (GD-5677): mit festem innerem Plastikkern, mit Silikon bedeckt
  
• Harz Zahnkeile (GD-5678): vier Größe, Xs/s/m/l
  
• Diamantkeile (GD-5679): sieben Größe, X-small/klein/mittel/groß/tiefe/l-medium/l-large
  
• Tulwar Keile (GD-5680): Drei Größe, Klein/mittel/groß
  

Hölzerne Zahnkeile

Material: Meistens Birken oder Kiefern, sterilisiert. Birkenkeile mit einem Wassergehalt von 12% kann sich um bis zu expandieren 18.7% In 30 Minuten in einer Gingivalflüssigkeitsumgebung. Diese adaptive Eigenschaft macht sie besonders geeignet für Fälle von Gingivalrezession bei alten Patienten. Jedoch, Sorgfältig sollte aufgenommen werden: Überexpansion kann zu übermäßigem Druck auf die parodontale Membran führen, Auslösen postoperativer Empfindlichkeit.

Vorteile:

• Natürlich Wasserabsorben und anschwellbar, intraoperativ besser an die Lücke passt.
• Starr, Geeignet für die hohe Stärke der Höhlen der Klasse II geeignet.

Nachteile:

• Unbrauchbar, Überexpansion kann Beschwerden verursachen.

Probenanzeige:

Andere Typen

• Metallkeil: Selten, häufig für die vollständige Kronenvorbereitung oder spezielle restaurative Szenarien verwendet.
• Silikonkeil: weich und flexibel, geeignet für ästhetische Restaurationen, aber teurer.

2. Die drei Kernfunktionen des Zahnkeils

Zahntrennung

• Trennt die benachbarten Zähne vorübergehend durch 0.2-0.5 mm mit leichter mechanischer Kraft, um einen Betriebsraum zu schaffen.
• Dies verhindert,.
• Klinische Studien haben gezeigt, dass der ordnungsgemäße Einsatz von Keilen das Risiko einer Nahrungsmittelimpaktion durch bis zu bis hin zu verringern kann 60%.

Matrixbandstabilisierung

• Zahnkeile können beim Fixieren des Formteils helfen, Verhinderung der Leckage des restaurativen Materials und der Gestaltung der idealen Kontur.
• Hohlraum II Restorationen: die Kombination mit der Matrixbänder Stabilisierung ist die klassische Lösung.
• Restaurationen der Hohlraumklasse V: Normalerweise in Kombination mit einer gekrümmten Formplatte.

Gum protection and hemostasis

• Dental wedges can provide a certain degree of protection above the gums.
• After the dental wedge is inserted into the tooth, it will exert a slight pressure on the gum, reducing bleeding during the operation.

3. Application Skills in Filling and Repair

So wählen Sie den richtigen Keil aus

Insert the Angle and direction

The dental wedge should be inserted obliquely into the interdental space from the lingual or buccal side of the tooth, and the Angle should be controlled at 30° to 45°. The core purpose of this Angle design is to avoid the gum tissue, prevent direct compression or scratching of the gum during vertical insertion, and reduce the risk of postoperative gum redness, swelling and bleeding.

Insertion depth control

The top of the wedge should be slightly higher than the edge of the restoration by approximately 0.5mm. This reserved space is designed to compensate for the shrinkage during the curing process of subsequent filling materials (wie Harz), ensuring that the material can closely adhere to the edge of the tooth after curing and avoiding the formation of gaps that could lead to secondary caries.

Clinical precautions

Avoid excessive pressure on the gums: Während des Betriebs, the insertion force of the dental wedge should be controlled. Excessive pressure can damage the attachment relationship between the gums and the teeth, which may cause postoperative gum recession. Clinical statistics show that the incidence of such complications is approximately 3% Zu 7%.

Precise positioning of the insertion position: If the dental wedge is inserted at an offset position (such as being too close to the occlusal surface or the root tip direction), it may cause the contact points of adjacent teeth to be too loose, thereby affecting the stability of the normal occlusal relationship. Patients may experience problems such as weak bite and food impaction.

Actual case: Repair of deep wedge-shaped defect

Taking the repair of a deep wedge-shaped defect of the left lower first premolar as an example, the specific operation and therapeutic effect are as follows:

• Preoperative assessment: The patient was a 45-year-old adult. The cervical defect of the left lower first premolar had reached the deep dentin, accompanied by obvious cold and heat sensitivity symptoms. The Visual Analogue Scale (VAS) was used to assess the sensitivity degree, with a score of 6/10.
• Key operation techniques: Erste, use the No. 00 gingival line for gingival drainage treatment. Dann, insert a pre-moistened pine wedge and let it stand for 15 minutes until it fully expands to widen the tooth gap. Nächste, fluid resin is used as the base, and then 3M Z350XT resin is used for layered filling. The wedges should be retained until the resin has initially cured before being removed to prevent material deformation during the filling process.
• Postoperative efficacy: The patient was followed up for one year after the operation. The examination showed that the integrity rate of the restoration reached 98%, with no loosening, detachment or secondary caries. The patient’s cold and heat sensitivity symptoms completely disappeared, and the occlusal function returned to normal.

4. Purchasing Criteria for Dental Wedges ‌

Materialssicherheit Priorität

Core certification standards

The material and sterilization treatment of the wedge must comply with professional medical standards. Different materials correspond to clear certification requirements:

• Plastic wedges: Must have FDA (Food and Drug Administration of the United States) or CE (European Union Product Safety Certification) medical-grade polymer certification. The core needs to avoid harmful substances such as phthalates, which may migrate through contact and pose potential health risks. Compliance certification is the key basis for ensuring the safety of materials.
• Wooden wedges: A complete EO (ethylene oxide) sterilization report must be provided, and the report should clearly state that the biological load is ≤10⁻⁶ (D.h., the probability of microbial survival after sterilization does not exceed one in a million), ensuring that there are no pathogenic bacteria remaining before use to avoid cross-infection or postoperative inflammation.

Key points to avoid pitfalls in procurement

When purchasing, be cautious of non-medical grade products and especially reject “industrial wooden wedges” without any marking. Most of these products are made from leftover materials from industrial processing and have not undergone medical-grade treatment. They may contain harmful chemicals such as formaldehyde. When used, they not only easily irritate the gum tissue but may also be absorbed through the oral mucosa, posing a threat to the patient’s health. Darüber hinaus, there are no unified standards for their size and hardness, which cannot meet the precise operation requirements of dental restoration.

Maximize the size fit rate

When choosing wedges, it is necessary to combine the actual clinical needs and maximize the size fit rate through “preoperative assessment + multi-specification reserve”.

Before the operation, the size of the required wedge should be initially determined based on the width of the interdental gap of the affected tooth (such as the interdental caries gap, wedge-shaped defect gap) and the tooth morphology (such as deciduous teeth and permanent teeth, normal teeth and inclined teeth).

It is recommended to stock up on multiple sizes of wedges (such as thin, Medium, dick, or thin and thick styles for special tooth gaps) to avoid poor fit due to insufficient single size, which may affect the gap opening effect or cause gum compression. This ensures that a matching model can be found for different cases, improving operational efficiency and restoration quality.

5. Abschluss

Although dental wedges are small in size and seem insignificant, they are indispensable “key supporting roles” in dental restoration operations. From material selection to standardized use, precise control over every link is not only the core guarantee for enhancing the stability of the restoration and reducing postoperative complications, but also can effectively improve the patient’s diagnosis and treatment experience and lay a foundation for a long-term good prognosis.