Quartiers dentaires: Un outil essentiel en dentisterie réparatrice

Bien que petit, Les coins dentaires jouent un rôle irremplaçable dans la dentisterie réparatrice. Ils sont principalement utilisés pour la séparation des dents, stabiliser les bandes matricielles et façonner les bords des restaurations. Selon le matériau et la conception, Les performances cliniques et l'utilisation des coins varient. Dans cet article, Nous analyserons systématiquement les types de quartiers dentaires, leurs propriétés matérielles, leurs principales fonctions et leur application en remplissage et restauration.

1. Types de coins dentaires et de propriétés de matériaux

Quartiers dentaires en plastique

Matériel: Souvent fait de polypropylène médical (Pp), flexible.

Avantages:

• L'élasticité modérée réduit la pression sur les gencives.
• Peut être stérilisé à des températures élevées et convient à la réutilisation.

Désavantage:

• Support limité, pas adapté aux cas avec caries profondes ou des lacunes serrées.

Échantillon d'affichage:

• gardes de coins dentaires (GD-5675): avec trou avec rblade
  trois taille: Grand / moyen / petit
  
• cales adaptatives (GD-5677): avec un noyau en plastique intérieur ferme, couvert de silicone
  
• quartiers dentaires en résine (GD-5678): quatre taille, XS / S / M / L
  
• quartiers de diamant (GD-5679): sept taille, X-Small / Small / Media
  
• Cales de Tulwar (GD-5680): trois taille, Petit / moyen / grand
  

Quartiers dentaires en bois

Matériel: principalement bouleau ou pin, stérilisé. Coins de bouleau avec une teneur en eau de 12% peut se développer jusqu'à 18.7% dans 30 minutes dans un environnement de liquide gingival. Cette propriété adaptative les rend particulièrement adaptés aux cas de récession gingivale chez les anciens patients. Cependant, Il faut prendre soin: La surexpansion peut entraîner une pression excessive sur la membrane parodontale, déclencher une sensibilité postopératoire.

Avantages:

• Naturellement absorbant à l'eau et gonflable, Meilleur ajustement à l'écart en peropératoire.
• Rigide, Convient pour le soutien à haute résistance aux cavités de classe II.

Désavantage:

• Non-reusable, La surexpansion peut causer de l'inconfort.

Échantillons Afficher:

Autres types

• Coin de métal: Rare, couramment utilisé pour la préparation complète de la couronne ou les scénarios de restauration spéciaux.
• Coin de silicone: doux et flexible, Convient aux restaurations esthétiques, mais plus coûteux.

2. Les trois fonctions principales du coin dentaire

Séparation des dents

• Sépare temporairement les dents voisines par 0.2-0.5 mm avec une force mécanique légère pour créer un espace de fonctionnement.
• Cela empêche la restauration de surplomber et restaure la forme naturelle des points voisins.
• Des études cliniques ont montré que l'utilisation appropriée des coins peut réduire le risque d'impaction alimentaire 60%.

Stabilisation de la bande matricielle

• Les quartiers dentaires peuvent aider à réparer la pièce de moulage, Empêcher la fuite du matériau réparateur et façonner le contour idéal.
• Cavité II Restaurations: la combinaison avec le Bandes matricielles La stabilisation est la solution classique.
• Cavity Class V Restorations: généralement en combinaison avec une plaque de moulure courbe.

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

Comment choisir le bon coin

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 (comme la résine), 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: Pendant l'opération, 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% à 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: D'abord, use the No. 00 gingival line for gingival drainage treatment. Alors, insert a pre-moistened pine wedge and let it stand for 15 minutes until it fully expands to widen the tooth gap. Suivant, 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 ‌

Priorité de sécurité des matériaux

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 (C'est-à-dire, 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. De plus, 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, moyen, épais, 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. Conclusion

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.