The development of modern restoration methods makes it possible to functionally and aesthetically restore teeth. One such method is the technology of using a silicone key.
A silicone key in dentistry is a technique for restoring the anatomical shape of teeth using silicone impressions. These keys are made using a plaster model. The defect is restored with wax.
An occlusal silicone key is used to accurately follow the anatomical shape. This is especially true for the palatal surface. The template is used for the restoration of both frontal and lateral molars. To obtain the most reliable copy, the template must cover the gum area and adjacent teeth.
The template is made from A-silicone directly in the oral cavity, an impression is taken, and the cutting edge of the tooth being restored and two adjacent ones on opposite sides are captured for reliable support. The resulting impression is cut along the line formed by the cutting edge.
Features of restoration
The silicone key method in therapeutic dentistry is an innovative development that allows for maximum aesthetic appearance and anatomical shape of the tooth being restored.
This technique significantly reduces the time required for restoration. This technology is also used to eliminate hidden forms of caries characteristic of molars of the chewing group. The carious cavity is filled with composite material, and the final portion is modeled with a template. At the same time, to eliminate the influx of material, outlet channels are created in the key.
The impression can be made without using a spoon. The restoration procedure can be performed in several stages with layer-by-layer application of the material. Instructions for using a silicone key in dentistry can be seen in the video.
Features of the procedure
In dental therapy, the silicone key method is an innovative solution. The technique reduces the time spent on restoration.
It is used to eliminate invisible dental caries. The cavity of the damaged unit is filled with a filling compound, and the last portion is given the correct shape using a template. Outlet channels are cut to prevent the composition from flowing.
It is possible to create an impression without a spoon. The work is carried out in stages, applying the composition layer by layer.
Indications and contraindications
Indications for the use of a silicone key are the following patient conditions:
- recovery from injuries in the form of chips;
- the need to replace old fillings;
- treatment of caries in the primary stages;
- need for aesthetic restoration.
Since silicone group materials are used, some patients may experience allergic reactions to them. Such cases are contraindications for the use of silicone template technology.
Advantages and disadvantages of technology
Silicone template (key) technology allows you to achieve the following results:
- significant savings in recovery time;
- the palatal surface optimally matches the natural one, the occlusal plane is almost natural and suits the patient (at the final stage of restoration, some adjustment is required at the points of closure of the teeth);
- absolute symmetry along the contour between the cutting edges of the canines and incisors;
- controllability of the process of applying composite materials and, as a result, optimal thickness, requiring minimal finishing.
Not without certain shortcomings. These include the following factors:
- silicone is a hard material, which does not make it possible to fully display micro anatomy;
- silicone is subject to deformation when composite materials are pressed;
- work is limited to a single-pack execution technique;
- the use of latex fabric makes it difficult to work with the silicone block.
Recent developments use a carrier (applicator) and fluid composite materials, which allows you to get as close as possible to the anatomical structure when taking impressions.
Silicone key. Application technique.
What is a “silicone key”? What's behind this name?
It's actually quite simple. And further we will consider the traditional technique of its use in direct composite restoration. First, you need to understand why a “silicone key” is needed.
Many dentists involved in direct restoration have noticed that creating a natural palatal surface when restoring incisors and canines is quite difficult, and restoring the incisal edge is not an easy task.
Therefore, when using the “silicone key” technique, we get
- optimal relief of the palatal surface, with the necessary occlusal plane (in the final restoration, minor adjustments to the points of closure of the teeth will be required)
- absolute symmetry of the contour of the cutting edge of the incisors and canines
- ability to control the thickness of applied layers of composite material
- and finally, significant savings in restoration time
But let's move directly to the technique itself. Let's consider the classic version using a clinical case as an example.
In the photo we see a typical fracture of the upper left central incisor; in this case, endodontic treatment had already been carried out and the task ahead was to restore the lost part of the tooth crown. Considering the absence of a palatal tubercle and the absence of a cutting edge, the need arose for wax-up modeling. Impressions were taken, models were made and the incisor was restored from wax.
Then, using a silicone impression mass, an impression is made of the restored and adjacent teeth. It is necessary to obtain an accurate impression of the palatal surface and incisal edge. If necessary, you can trim the edges of the resulting impression with a scalpel; you need to obtain visualization of the entire contour of the tooth.
Next, we isolate the teeth using a rubber dam; you can read about the application features here, and we carry out the preparation. In this case, this is the removal of a temporary filling and the creation of a fold.
We try on the silicone key in the work area and mark the edge of the restoration. Next, we place the restoration material in the key in a thin layer (usually an enamel shade) and apply it to the prepared tooth.
Stages of dental restoration
Teeth restoration using silicone template technology is performed in the following sequence:
- Definition of color . At the first stage, it is necessary to decide on the color of the incisor or molar to be restored.
- Shape modeling . Wax is used and the shape of the tooth is repeated on the model. The extracted model serves as the basis for making a silicone template. This technique is called Wax-up by dentists.
- Mock-up . Direct modeling of the anatomical shape of teeth in the oral cavity.
- Making a key . The taken silicone impression serves as the basis for making a silicone template of the palate surface.
- Preparation . When using the Mock-up technique, composite materials are first removed from the oral cavity, then grinding (preparation) of the cavity with caries is performed. If necessary, for the purpose of aesthetic restoration, pigment tissue is removed from the enamel surface. To ensure a smooth color transition between artificial and natural tissues, the dentist creates a bevel of the enamel surface.
- Cleaning . Using abrasive pastes and special tools (brush attachment), teeth are cleaned.
- Etching . For etching and application of adhesive material, it is necessary to ensure reliable protection of teeth from contact with saliva secretions.
- Securing the key . A composite material of the desired shade is applied to the silicone matrix (cutting edge). The finished silicone template is fixed on the tooth surface from the palatal side. Then a base tint enamel is applied. The process is performed from the palatal surface. Thus, the template sets the shape for further application of the composite in several layers.
- Applying the base shade of enamel . To form the dental approximal surface, it is necessary to install a special matrix. After this, the dentist applies a base shade of enamel.
- Application of dentin . At the next stage, layer-by-layer application of the dentin surface occurs. The restoration is performed in the direction from the oral to the vestibular surface.
- Overlaying color . Applying the required enamel color tone completes the restoration stage.
- Hardening and cleaning . The resulting enamel is dried until hardened and then mechanically cleaned.
- Polishing . At the final stage, the restored surface is polished using special silicone nozzles at low speeds.
As a result, after all the manipulations, the patient has a restored incisor that is practically no different in anatomy and color.
Indications
Making a silicone key is indicated for certain conditions:
- rehabilitation period after traumatic injuries of individual elements;
- removal of outdated and damaged fillings;
- treatment of initial manifestations of carious damage;
- the need for aesthetic restoration.
A contraindication is a history of allergic reactions to latex.
Advantages and disadvantages
Positive results of using occlusal template technology:
- shortened recovery period;
- the relief of the palatal wall is close to the anatomical one;
- the occlusal plane is created perfectly;
- the contours between the cutting edges of the incisors and canines are symmetrical;
- controlled application of the composite;
- minimal final processing of the layer.
There are also a number of noteworthy negative factors:
- the rigidity of silicone does not allow reliably depicting micro anatomy;
- dental silicone is deformed when the composite is pressed;
- single-pack execution technique;
- difficulties in interacting with the silicone block due to the use of the cathedral.
Successive stages of restoration work
Restoration using latex template technology in stages:
- The doctor selects the color of the unit being restored.
- Shape modeling. Using wax, the shape of the tooth is reproduced on the model. The finished model is removed and serves as a prototype for creating a silicone template. The name of the technique is Wax-up.
- Mock-up. Direct modeling of the natural tooth shape in the patient's mouth.
- Making a key. The taken impression of the palatal surface serves as the basis for creating a template.
- Mock-up involves preliminary removal of the composite from the mouth. Then the carious cavity is prepared. If necessary, the enamel is cleaned from tartar. The doctor creates a bevel of the enamel layer.
- Teeth are cleaned with a brush and pastes with abrasive substances.
- Etching. The doctor ensures that the units are protected from saliva. Etching and application of adhesive composition are carried out.
- Fastening the template. A filling material of the selected shade is applied to the sharp edge. The created template is attached to the side of the sky wall.
- Applying the main shade of enamel. A special matrix is pre-installed to create the dental approximal surface.
- Application of dentin. The material is applied in layers, starting from the oral and towards the vestibular surface.
- Applying colored enamel.
- The hardened artificial layer is dried and cleaned by machine.
- Polishing with latex nozzles at low engine speed.
The created artificial incisor has a shade, function and anatomical specificity identical to a natural tooth.
What does the cost consist of?
The price of the procedure is determined by many factors. The cost is influenced by the raw materials, the professionalism of the doctor, the number of units being restored, and the equipment of the clinic. In private clinics with a decent level of service, the procedure is more expensive than in municipal dentistry.
The introduction of this method into dental practice saves dentists time and minimizes the risk of complications. The doctor reproduces the necessary relief of the palatal and occlusal surface. No occlusal-articulatory correction is required. At the same time, the key manufacturing method is characterized by simplicity, reliability and speed of execution.
Price
Pricing policies vary and depend on many factors. Raw materials, technological equipment, and the level of personnel qualifications affect the price level for dental restoration using the occlusal key method. Private clinics will offer patients a high-quality level of service, but prices will be higher than when visiting public clinics.
The cost also depends on the number of units restored. You can find out all the information about the price lists for the services provided directly by visiting the websites or by calling medical institutions.
Dental restoration using the silicone key technique is an invasive technology. This technique allows you to restore the functionality of teeth with minimal time.
Teeth treated and restored in this way do not differ from real ones and serve for a long time. Aesthetic restoration allows you to correct defects, shape, color, etc. The patient spends less time compared to traditional methods of dental restoration.
