小さいですが, 歯のくさびは、修復歯科でかけがえのない役割を果たします. それらは主に歯の分離に使用されます, マトリックスバンドを安定化し、修復の端を形作ります. 材料とデザインに応じて, 臨床性能とウェッジの使用はさまざまです. この記事で, タイプの種類を体系的に分析します 歯のくさび, それらの材料特性, 彼らの主な機能と充填と修復への適用.
1. 歯のくさびと材料特性の種類
プラスチック製の歯のくさび
材料: 多くの場合、医療ポリプロピレンでできています (pp), フレキシブル.
利点:
- 中程度の弾力性は、歯茎への圧力を軽減します.
- 高温で滅菌することができ、再利用に適しています.
短所:
- 限られたサポート, ケースには適していません 深い虫歯 またはタイトなギャップ.
サンプルディスプレイ:
- 歯のくさびの警備員 (GD-5675): rbladeの穴があります
3つのサイズ: 大/中/小さい
- 適応ウェッジ (GD-5677): しっかりした内側のプラスチックコアを使用, シリコンで覆われています
- 樹脂歯のくさび (GD-5678): 4つのサイズ, xs/s/m/l
- ダイヤモンドウェッジ (GD-5679): 7つのサイズ, X-Small/Small/Medium/Large/Deep/L-Medium/L-Large
- タルワールウェッジ (GD-5680): 3つのサイズ, 小/中/大
木製の歯のくさび
材料: 主にバーチや松, 滅菌. の水分量が付いたカバノキのくさび 12% まで拡張できます 18.7% で 30 歯肉液環境の数分. この適応施設により、古い患者の歯肉不況の症例に特に適しています. しかし, 注意を払う必要があります: 過剰拡張は、歯周膜に過度の圧力につながる可能性があります, 術後の感度を引き起こします.
利点:
- 自然に水吸収性と膨潤性, 術中にギャップに適しています.
- 剛性, クラスIIキャビティの高強度サポートに適しています.
短所:
- 使用できない, 過剰拡張は不快感を引き起こす可能性があります.
サンプルが表示されます:
他のタイプ
- メタルウェッジ: レア, 完全なクラウンの準備または特別な修復シナリオに一般的に使用されます.
- シリコンウェッジ: 柔らかく柔軟です, 審美的な修復に適しています, しかし、よりコストがかかります.
2. 歯のくさびの3つのコア関数
歯の分離
- 隣接する歯を一時的に分離します 0.2-0.5 動作スペースを作成するための軽い機械的な力を持つMM.
- これにより、回復が張り出しないようにし、隣接するポイントの自然な形状を回復します.
- 臨床研究では、ウェッジを適切に使用すると、食物衝突のリスクを減らすことができることが示されています。 60%.
マトリックスバンド安定化
- 歯のくさびは、成形ピースの修正に役立ちます, 修復材料の漏れを防ぎ、理想的な輪郭を形作る.
- キャビティIIの修復: との組み合わせ マトリックスバンド 安定化は古典的なソリューションです.
- キャビティクラスVの修復: 通常、湾曲した成形プレートと組み合わせて.
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
正しいウェッジを選択する方法
| 基準 | 推奨されるウェッジタイプ |
|---|---|
| 狭い近位空間 | 木製のウェッジ, it’s expand and fit together after getting wet |
| 広い近位スペース | プラスチックウェッジ, elastic fit |
| 軽い樹脂 | Clear plastic wedges, facilitate light penetration |
| アマルガムの詰め物 | 木製のウェッジ, it can offer stronger support |
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 (樹脂など), 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: 操作中, 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% に 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: 初め, use the No. 00 gingival line for gingival drainage treatment. それから, insert a pre-moistened pine wedge and let it stand for 15 minutes until it fully expands to widen the tooth gap. 次, 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
物質的な安全の優先事項
Core certification standards
The material and sterilization treatment of the wedge must comply with professional medical standards. Different materials correspond to clear certification requirements:
- プラスチックウェッジ: 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.
- 木製のウェッジ: A complete EO (ethylene oxide) sterilization report must be provided, and the report should clearly state that the biological load is ≤10⁻⁶ (すなわち, 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
購入するとき, 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. さらに, 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, 中くらい, 厚い, 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. 結論
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.
