Session
Dr.10月 3日（土）
13:30 - 15:00
4F〜6FホールC
Session50
Shaping the Future: Preparation Strategies for Long-Term Clinical Success
未来を形づくる: 長期予後を成功に導くプレパレーション
Lecturer
Overlay preparation: How to manage
Overlay preparation: How to manage
- Diagnosis
- Basic Design Principles
- Applications in Various Situations
- 診断
- 基本的な形成デザイン
- 様々なシチュエーションでの応用法
Overlayの研究データやケースレポートは現在数多く報告されており、論文中でもその術式や形成デザインは確立されつつある。 応力試験において、Overlayは修復物だけでなく支台歯に関しても他の修復法に比較し、応用が緩和されることが言及されている。 臨床応用することで、様々な利点があるため、私自身も臨床でこの修復法を応用し同様に良い結果が出ている。 しかし、臨床では様々なシチュエーションがあり、その形成デザインにおける考え方も異なる。 今回この講演では、Overlayを自分の臨床でどのように考え、実践しているか。 症例を供覧頂きながら治療における勘所をお話ししたいと思う。
Lecturer
Evidence-based Criteria and Scientific Logic for Cavity Preparation Achieving Excellent Long-term Prognosis — From Minimally Invasive Caries Removal and Immediate Dentin Sealing to Adhesive Lining
良好な長期予後を実現する窩洞形成の判断基準と科学的論理
――低侵襲う蝕除去・象牙質レジンコーティングから接着ライニングまで
- Criteria for Cavity Preparation
- Minimally Invasive Caries Removal
- Immediate Dentin Sealing (IDS) and Adhesive Lining
- 窩洞形成の判断基準
- 低侵襲う蝕除去
- 即時象牙質封鎖(IDS)および接着ライニング
修復の長期予後は、材料の選択よりも形成段階における意思決定の質によって規定される。本講演では、この視点に立ち、低侵襲う蝕除去における選択的除去の概念、象牙質レジンコーティングおよびライニング（IDS）、Deep Margin Elevation（DME）などといった接着性材料の応用による力学的・生物学的補強の科学的な有用性と意義を、臨床症例を通じて体系的に解説するとともに、長期的成功に導く実践的プロトコルを提示する。
Lecturer
Innovations in Anterior Veneer Preparation: Clinical Considerations for New-Generation Materials
Innovations in Anterior Veneer Preparation: Clinical Considerations for New-Generation Materials
- Paradigm Shift in Tooth Preparation: From Macro-Retention to Material-Centric Bonding
- Margin Design According to Material Optical Properties
- Surface Treatment and Immediate Dentin Sealing (IDS) Integration
- Paradigm Shift in Tooth Preparation: From Macro-Retention to Material-Centric Bonding
- Margin Design According to Material Optical Properties
- Surface Treatment and Immediate Dentin Sealing (IDS) Integration
Point 1: Redefining Preparation Depth and Volume
_ Concept of "Material-Driven Preparation": New-generation high-strength ceramics require minimum thickness for optimal fracture resistance .
_ Shift in Philosophy: Moving away from bulk reduction for retention; instead, creating a uniform "envelope" of space to utilize the material's natural translucency and color.
_ Clinical Tip: Use depth gauges calibrated to the specific material's required thickness.
Point 2: Margin Placement and Design Based on Material Optics
_ Material Classification by Opacity:
_ High Translucency (e.g., LT, MT ceramics): Require more extensive preparation to mask underlying discoloration, often needing facial reduction extending to the proximal line angles.
_ High Opacity (e.g., zirconia): Allow for more conservative margins but demand different finishing lines to support the frame.
_ Decision Tree: Determining wrap vs. no-wrap preparations based on the final shade target and material selected.
Point 3: Adhesive Integration and Surface Conditioning
_ The Role of IDS: Protecting pulp, reducing sensitivity, and creating a stable hybrid layer before impression taking.
_ Material-Specific Bonding:
_ Glass Ceramics: Hydrofluoric acid etching + silane.
_ Resin-Matrix Ceramics: Focus on mechanical interlocking via aluminum oxide abrasion or specialized primers.
_ Conclusion: The adhesion protocol is as critical as the preparation itself; mismatch leads to failure.
_ Concept of "Material-Driven Preparation": New-generation high-strength ceramics require minimum thickness for optimal fracture resistance .
_ Shift in Philosophy: Moving away from bulk reduction for retention; instead, creating a uniform "envelope" of space to utilize the material's natural translucency and color.
_ Clinical Tip: Use depth gauges calibrated to the specific material's required thickness.
Point 2: Margin Placement and Design Based on Material Optics
_ Material Classification by Opacity:
_ High Translucency (e.g., LT, MT ceramics): Require more extensive preparation to mask underlying discoloration, often needing facial reduction extending to the proximal line angles.
_ High Opacity (e.g., zirconia): Allow for more conservative margins but demand different finishing lines to support the frame.
_ Decision Tree: Determining wrap vs. no-wrap preparations based on the final shade target and material selected.
Point 3: Adhesive Integration and Surface Conditioning
_ The Role of IDS: Protecting pulp, reducing sensitivity, and creating a stable hybrid layer before impression taking.
_ Material-Specific Bonding:
_ Glass Ceramics: Hydrofluoric acid etching + silane.
_ Resin-Matrix Ceramics: Focus on mechanical interlocking via aluminum oxide abrasion or specialized primers.
_ Conclusion: The adhesion protocol is as critical as the preparation itself; mismatch leads to failure.
Lecturer
From Margins to Longevity: Adhesive Strategies and Long-term Outcomes in Adhesive Restorations
From Margins to Longevity: Adhesive Strategies and Long-term Outcomes in Adhesive Restorations
- Adhesive restoration minimizes tooth reduction while preserving the remaining tooth structure
- Marginal preparation should be tailored to the tooth location
- Long-term prognosis is the ultimate indicator of restorative success
- Adhesive restoration minimizes tooth reduction while preserving the remaining tooth structure
- Marginal preparation should be tailored to the tooth location
- Long-term prognosis is the ultimate indicator of restorative success
In contemporary dental practice, adhesive restoration has become virtually synonymous with direct restorative procedures. The most significant advantage of adhesive restoration is its ability to minimize additional tooth reduction beyond the area of defect, thereby preserving as much sound tooth structure as possible. This conservative approach not only aligns with the principles of minimally invasive dentistry but also contributes to the long-term structural integrity of the tooth. However, despite these advantages, appropriate marginal preparation remains a critical factor for achieving predictable and durable outcomes.
Moreover, the location of the cavity margin within the tooth―whether it is positioned in enamel, dentin, or near the cemento-enamel junction―can significantly influence the choice of adhesive strategy and the overall clinical approach. Each substrate presents distinct structural and chemical characteristics, which in turn affect bonding performance and long-term stability. Therefore, a thorough understanding of these differences is essential for optimizing restorative success.
This lecture aims to explore the theoretical background underlying adhesive strategies based on the location of the cavity margin and to critically evaluate their clinical relevance. Through selected clinical cases, the practical application of these principles will be discussed, with particular emphasis on achieving predictable long-term outcomes.
Moreover, the location of the cavity margin within the tooth―whether it is positioned in enamel, dentin, or near the cemento-enamel junction―can significantly influence the choice of adhesive strategy and the overall clinical approach. Each substrate presents distinct structural and chemical characteristics, which in turn affect bonding performance and long-term stability. Therefore, a thorough understanding of these differences is essential for optimizing restorative success.
This lecture aims to explore the theoretical background underlying adhesive strategies based on the location of the cavity margin and to critically evaluate their clinical relevance. Through selected clinical cases, the practical application of these principles will be discussed, with particular emphasis on achieving predictable long-term outcomes.
