Ex.5. Find comparative degree. Найдите сравнительную степень.

Ex.6. Answer the questions. Ответьте на вопросы.

1. What is the preventive resin restoration?

2. Where is preventive resin restoration used?

3. What must radiograph show?

4. What is easy to detect clinically?

5. How is softness determined?

6. When is the aria of carious?

7. What is difficult for patient to clean?

8. Are sealants recommended for those teeth?

9. What is evidence of carries?

10. What surrounds the affected area?

11. What is the indication for a preventive resin restoration?

 

Ex.7 Say some words about diagnosis. Use the information from the text. Скажите несколько слов о диагнозе. Используйте информацию из текста.

Preventive resin restorations: indications, technique and success.

Part 2.

Technique.

Several methods for preparing preventive resin restorations are described in the literature. All are accomplished using the following treatment sequence:

a) anesthesia and isolation,

b) preparation,

c) restoration,

d) sealant application.

1. Administer local anesthesia.

Although optional, infiltration or block anesthesia should be considered for the patient ′s comfort. Application of the rubber dam retainers may be painful.

2. Isolate with rubber dam.

A procedure involving conditioning with acid, application of composite resin and sealant, and possible use of glass - ionomer lining cement is technique sensitive. Each of these steps is sensitive to moisture contamination. A rubber dam prevents salivary contamination of the treatment area.

3. Remove caries.

There are no rules of cavity design because this is a bonded restoration. The goal is to remove all caries and as little tooth structure as possible. Small burs are used to conserve tooth structure and help ensure a narrow cavity preparation.

4. Provide pulpal protection if necessary.

If caries removal extends deeply into the dentine, calcium hydroxide and glass -ionomer liners are indicated. Calcium hydroxide stimulates reparative dentine when the preparation approaches the pulp. Glass-ionomer lining cement bonds to dentine, provides a surface to which the composite resin micromechanically bonds, and realeases fluoride to the cavity walls.

5. Clean the occlusal surface.

Maximal bond strengths are obtained when a prophylaxis is given prior to acid conditioning. While there is no evidence to confirm the value of using pumice instead of other cleaning agents, it is believed that flavored, oil-based or fluoride-containing prophylaxes pastes may influence the conditioning of the enamel.

6. Condition the entire occlusial surface.

Conditioning creates pores in the enamel and enables the microscopic infiltration of the dental resin into the tooth surface, where it polymerizes and bonds. Etching of the glass –ionomer cement is also recommended. Within the narrow confines of cavity preparation, it sometimes is difficult to avoid etching the glass-ionomer lining cement. Washing removes the calcium- phosphate reaction products of phosphoric and conditioning agents and enamel. The tooth is washed for 10 to 20 seconds to archive maximal bond strength.

7. Place bonding agents.

Use of a bonding agent improves the bond strength between a glass-ionomer cement and composite resin. If the cavity preparation is limited to enamel, and glass-ionomer cement is not used, a bonding agent is still employed.

8. Place a posterior composite resin into the preparation.

The composite resin micromechanically bonds to the conditioned enamel and provides an effective marginal seal. Bonding occurs between the composite resin and prepared glass-ionomer cement and dental walls. Placing the proper amount of composite resin is easier to accomplish when a light-curing product is used.

9. Apply sealant.

Sealant prevents caries of the pits and fissures that were not included in the cavity preparation.

10. Equilibrate occlusion.

Unfilled sealants were quickly to accommodate a patient’s occlusion, but semi filed sealants are more abrasion resistant and require removal of high spots.

 

Words to the text Preventive resin restorations: indications, technique and success. (Part II).

1) Anesthesia and isolation-анестезия и изолирование

2) Sealant application-применение пломб

3) The rubber dam retainers- фиксаторы резинового изолятора слюны

4) An acid-кислота

5) Glass-ionomer lining cement –цементирующий слой, образуемый стеклянным иономером

6) Pulpal protection-защита пульпы

7) To bond-связывать, скреплять

8) A pumice-пемза

9) Fluoride containing prophylaxis pastes-профилактические пасты, содержащие фтор

10) The calcium-phosphate reaction-реакция кальций-фосфат

11) A bonding agent- связующий агент

12) A posterior composite resin-последующая композиционная пластмасса

13) A marginal seal-кровавое уплотнение

14) A light curing product-продукт для легкого лечения

15) Equilibrate occlusion-«уравновешенный прикус»

16) semi filled agents-наполовину заполненные пломбы

 

Exercises to the text “Preventive resin restorations: indications, technique and success. (Part II).”

Ex. 1. Say in Russian. Скажите по-русски.

Are accomplished; a restoration; although optional; infiltration; a procedure involving conditioning with acid; to moisture contamination; small burs; a narrow cavity preparation; calcium hydroxide; micromechanically; fluoride; to confirm; oil-based; the conditioning of the enamel; polymerizes; etching of the glass-ionomer cement surface; maximal bond strength; occurs; dental walls; to accomplish; are more abrasion resistant.

 

Ex. 2. Say in English. Скажите по-английски.

Последовательность лечения; для комфорта пациента; возможное использование; заражение слюны; цель; сохранить структуру зуба; глубоко проникает; пульпа; очищающие агенты; создает поры; инфильтрация; рекомендовано; эмаль; достигнуть; ограничено; еще задействованы; достаточное количество; не включены; требует восстановление.

 

Ex. 3. Find Passive Voice, Participle I, Participle II. Найдите пассивный залог, причастие настоящего и прошедшего времени.

Ex.4. Find V, V_s. Найдите V, V_s.

Ex.5. Answer the questions. Ответьте на вопросы.

1. Where are several methods for preparing preventive resin restorations described?

2. What should be considered for the patient’s comfort?

3. What is technique sensitive?

4. Are there rules of cavity design?

5. Why are small burs used?

6. What does calcium hydroxide stimulate?

7. What does glass-ionomer stimulate?

8. When are maximal bond strength obtained?

9. When does conditioning create?

10. How long is the tooth washed?

11. What improves the bond strength between the glass-ionomer cement and composite resin?

12. What provides an effective marginal resin?

13. What does sealant prevent?

14. Were unfilled sealants quickly to accommodate a patients occlusion?

 

Preventive resin restorations: indications, technique and success.

Part 3.

Clinical success.

Simonsen and Stallard 1977 were the first to describe preventive resin restorations and to report the results of a clinical trial. Since then, a number of clinical reports have appeared. Studies have differed in the selection of teeth to be treated, in the whether caries should be removed, and the clinical technique used.

Azhardy treated a control group of teeth with occlusal amalgam restorations and noted that the preventive resin technique was 25 % less time-consuming than placing an amalgam restoration. Raadal compared a sealant and composite resin combination to sealants alone and found a slightly higher retention rate for the preventive resin restoration. Walls calculated that teeth treated with the amalgam restorations had 25% of the occlusal surface involved in the restoration, while teeth restored with the preventive resin restorations had 5% of the occlusial surface involved.

The cited studies employed different criteria to judge the success of preventive resin restorations. The most common cause of failure was wear of resin, which could be compensating for by the addition of more material at a recall visit.

205 teeth treated with preventive resin restorations, only 13 (6%) developed new lesions during a 4-year period. After 6.5 years, of 104 teeth still in the study, 11 had developed caries, and 65% of restorations were considered completely successful.

Discussion.

The principal advantage of preventive resin restorations over conventional ones is that they are less invasive. The most important and difficult decisions are made before the actual invasive step is begun. They are the caries status of the tooth and the treatment plan. A dentist’s diagnosis and treatment planning decisions vary greatly. Treatment recommendations ranged from sealants and preventive resin restorations to amalgam restorations.

The problem in clinical specificity is rooted in the subjectiveness of the diagnostic method as well as the lack of specific criteria indications for preventive resin restorations.

The caries criteria have been used in clinical caries trials for nearly a quarter of century, where diagnostic is paramount and have stood the test time.

A dentist could diagnose and remove caries in one pit, only to leave an untreated lesion in another pit. There is considerable clinical evidence that lesions will not progress and will become inactive, so this concern should not constitute a barrier to the use of preventive resin restorations.

One involves the use of glass-ionomer cement, instead of composite resin, restoration beneath the sealant.

The laminate technique takes advantage of desirable properties of each of the materials employed. The realize of fluoride by glass- ionomer cement to adjacent tooth structure is an additional benefit. The interlocking between the tooth and dental materials reduce gaps between the cavity walls and cavosurface margin and the restoration. The sealant provides further micromechanical interlocking over thec entire occlusal surface and protects from caries the sound pits and fissures not included in the cavity preparations.

The preventive resin restoration is the treatment of choice for small discrete lesions of pits and fissures.