Postupci u terapiji dubokih karijesnih lezija

master's thesis

• Title (english): Procedures in the treatment of deep carious lesions
• Author: Lucia Strihić
• Mentor: Ivana Miletić (mentor)
• Committee member: Ivana Miletić (predsjednik povjerenstva)
• Committee member: Silvana Jukić Krmek (član povjerenstva)
• Committee member: Anja Baraba (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Endodontics and Restorative Dentistry); Zagreb
• Defense date and country: 2019-01-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Endodonics and Restorative Dentistry

Abstract

Zubni karijes, bolest koja se može spriječiti i čija se prevalencija smanjila u mnogim zemljama
tijekom posljednja tri desetljeća i dalje ostaje najzastupljenija bolest diljem svijeta. Nastaje
uslijed demineralizacije cakline i dentina organskim kiselinama koje stvaraju mikroorganizmi
u zubnom plaku. Karijesna lezija se može razviti na glatkim plohama, okluzalnim plohama ili
na području vrata zuba. Kao zlatni standard u dijagnostici karijesne lezije koristi se vizualna
inspekcija u kombinaciji s rendgenskom snimkom (RTG). Danas su također razvijene brojne
dodatne dijagnostičke tehnike koje koriste sljedeće uređaje: DIAGNOdent/DIAGNOpen,
VistaProof/Cam, Soprolife, Soprocare, DIAGNOcam, Canary System, quantitative laser
fluorescence (QLF).
Početne nekavitirane karijesne lezije moguće je sanirati postupcima remineralizacije i
infiltracije dok je kod lezija indiciran operativni tretman u skladu s konceptom minimalne
intervencije.
Kavitirane karijesne lezije imaju dva sloja, vanjski sloj (inficirani dentin) i dublji sloj (afektirani
dentin) koji nije potrebno uklanjati.
Postupci koji se koriste kod uklanjanja karijesno promijenjenog zubnog tkiva su: neselektivno
uklanjanje do tvrdog dentina, uklanjanje karijesne lezije u dva posjeta tzv. „stepwise“
ekskavacija, selektivno uklanjanje do polutvrdog dentina, selektivno uklanjanje do mekog
dentina.
Tehnike za uklanjanje karijesnog tkiva dijelimo na rotirajuće i nerotirajuće. Rotirajuće tehnike
koriste čelična, karbidna, keramička i polimerna svrdla, dok se kod nerotirajućih koriste ručni
instrumenti (ekskavatori), zračna abrazija, ultrazvučni nastavci, laser, kemijska sredstva za
uklanjanje karijesa.
Uz pravilno izabran postupak i tehniku kod saniranja karijesnog dentina, potrebno je osigurati
stabilno sidrište za ispun tretiranog zuba kako bi se postiglo dobro brtvljenje i dugovječnost
takve restauracije. Od najčešće korištenih materijala za ispune se koriste kompozitni i
bioaktivni materijali.

Abstract (english)

Dental caries is a preventable disease and its presence has been declined in many countries over
the past three decades; however, it remains the most common disease worldwide. It occurs due
to the demineralization of enamel and dentine caused by organic acids from microorganisms in
dental plaque. Carious lesions develop on smooth surfaces, occlusal surfaces or in the cervical
area of the tooth. The golden standard in diagnosing caries lesions requires a visual inspection
and analyzing the X-ray. Today, numerous diagnostic techniques have also been developed,
such as: DIAGNOdent / DIAGNOpen, VistaProof / Cam, Soprolife, Soprocare, DIAGNOcam,
Canary System, QLF.
Initial non-cavitated carious lesions can be remineralized or infiltrated, whereas cavitated
carious lesions indicate operative treatment in accordance with the concept of minimal
intervention.
Cavitated carious lesions have two layers, an outer layer (infected dentin), and a deeper layer
(affected dentine) which can be retained.
The procedures used to remove cariously affected dental tissue are: non-selective removal to
hard dentine, "stepwise" removal, selective removal to firm dentine, selective removal to soft
dentine.
The techniques for removing carious tissue are divided into rotary and non-rotary techniques.
Rotary techniques utilize steel, carbide, ceramic and polymeric burs, while non-rotary
techniques include hand instruments (excavators), air-abrasion, ultrasonic extensions, lasers
treatment and caries removing agents.
A properly selected procedure and technique for repairing dentin caries requires stability of the
treated tooth with long-term restoration and good sealing of the margins. The most commonly
used restorative materials are composite resin and bioactive materials.

• Keywords: zubni karijes; kavitirana karijesna lezija; rotirajuće tehnike; nerotirajuće tehnike
• Keywords (english): dental caries; cavitated carious lesions; rotary techniques; non-rotary techniques
• Language: croatian
• URN:NBN: urn:nbn:hr:127:858524
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-10 09:18:13