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1、WhyCarryOutEstheticBondedRestorationsonPosteriorTeeth?Prevention과oralhygiene이잘유지되고있는35세환자의cariesfreemouth.Traditionalapproachusingamalgam:증례(1)recurrentcariesaroundoldcompositerestorationonM&PMcavityprep&pinplacementforamalgamcompletedamalgamfillingTraditionalapproachusin

2、gamalgam:증례(2)interproximalcarieson#14,15intactocclusalsurfacetraditionalapproachocclusalextensionprepforamalgam술후사진.MoreconservativeapproachusingadhesivetechniquesimilarcaseabovemaximumsoundtissuepreservativecavityformdirectcompositerestorationEvolutionofdecayedtootha)“c

3、lassical”approach“naturalcariesdecay”의진행,수복물의변성,mechanicalfailure발생빈법(leftarrow)unfavorablecondition:mesiodistalfissure로진행-prematurerootcanaltx.-protectivecrowning(rightarrow)onlay만으로더이상의진행prevention.B)“adhesive”approachmechanicalfailure발생감소.Fracturedtooth:증례(1)sensitivit

4、ytopressureintactonradiographydeepfracturedfissureonmesialsidedirectcompositerestoration으로sealing&reinforce:sensitivity감소Fracturedtooth:증례(2)frail&wideclass1amalgamfilling.(Nocuspalcoverage):spontaneous&pressureinducedpain일차적으로compositeinlay수복으로symptom완화시도.술후방사선사진:와동형성을심부

5、까지extension하지않음.Fracturedtooth:증례(3)superficialclass2:notvisibledefectbutthermalchange&pressure에sensitivitydeep,discolaoratedfissure(leakage)endodontictherapycrownforpreventfromfurthercrackprogressionpreventionform의retoration은많은양의치질삭제를요한다.Decmentationofgoldinlay부적절한margin

6、alfit으로severesecondarycaries발생.richblendcolor로naturalanatomy와esthetic,optimalfunction을만족시키고있는수복형태.newestheticmaterial의만족할만한long-termbehaviorafter5-yearafter9-yearBondedceramicinlay구치부심미수복중mostlonglasting.But,과정이복잡하고가격이비싸다after3-yearafter5-yearTraditionalapproachvsmoderna

7、pproachHISTORICALPERSEPECTIVE1)estheticintracoronalrestoration:notamodernconcept(1)1856prefabricatedceramicinlaysealedwithgoldfoil(2)1882firedceramicinlay(Herbest,Germany)(3)1888firedceramicinlaysoverplatinumfoil(Land)(4)1895ceramicinlaywasintroducedwellbeforeamalgam(5)1

8、905resinousadhesive+porcelainetching(Nyman)Lowfusingceramicinlay(Ducera)에fatiguetest(mechanicall