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Instrumentation

JPG - 175.9 ko
plateau pour reconstitution corono radiculaire au composite

Instruments mécanisés :

Instruments en distribution :

Instruments en salle de stérilisation :


Protocole

1- Choix de la teinte.

2- Mise en place de la digue

3- Déposer la reconstitution provisoire au dessus du traitement endodontique ou la couronne provisoire.

4- Préparation du logement :

  • Désobturer le canal avec les forets de Gates montés sur contre angle à vitesse rapide.
  • Passer les forets de Gates dans l’ordre croissant sans dépasser le diamètre 3 jusqu’à la longueur requise :
    • Le tenon doit dépasser l’hypomochlion de la dent et doit avoir une longueur supérieure à la couronne clinique.
    • Le diamètre du tenon ne doit pas dépasser le tiers du diamètre de la racine.
    • L’étanchéité apicale est assurée par au moins 5 mm de traitement endodontique sous le tenon.
  • Préparer le logement de tenon en passant le foret puis l’alésoir du diamètre choisi jusqu’à la longueur désobturée.
  • Ils seront soit tenus à la main à l’aide du porte instrument soit montés sur contre angle à basse vitesse sans irrigation.

5- Essayer le tenon et prendre une radio pour contrôler la longueur.

6- Scellement du tenon métallique pivomatic :

  • Enduire le tenon avec le ciment de scellement fuji plus et en déposer dans le canal.
  • Introduire le tenon dans son logement.
  • Nettoyer les excès avant la prise complète du ciment.

7- Mordançage :

  • Après la prise complète du ciment.
  • Appliquer l’agent de mordançage pendant 30 secondes sur l’émail et la dentine pendant 15 secondes sur la dentine.
  • Rincer abondamment.

8- Mise en place de la matrice transparente qui sera plaquée à la paroi à reconstituer par un coin de bois.

9- Mise en place de l’adhésif :

  • Appliquer l’adhésif attendre 10 secondes, sécher modérément et polymériser 20 secondes.
  • Appliquer une seconde couche d’adhésif, sécher immédiatement puis polymériser 20 secondes.
  • ATTENTION Ce protocole n’est valable que pour la marque de composite "..." utilisée a la faculté de chirurgie dentaire de Nantes pour touts autres marque suivre les recommandations du fabricant.

10- Obturation

  • Pour une cavité en site 1 :
    • Insérer une première couche de composite la fouler puis polymériser pendant 40 secondes.
    • Compléter l’obturation par couches successives obliques.
    • L’épaisseur des couches ne doit pas dépasser 2 mm.
    • La dernière couche sera sculptée pour rétablir l’anatomie occlusale avant polymérisation.
  • Pour une cavité en site 2 :
    • Reconstruire d’abord la paroi proximale manquante puis polymériser pendant 40 secondes et déposer le coin de bois et la matrice.
    • Continuer l’obturation comme pour une cavité de site 1
  • ATTENTION Ce protocole n’est valable que pour la marque de composite "..." utilisée a la faculté de chirurgie dentaire de Nantes pour touts autres marque suivre les recommandations du fabricant.

10- Dépose de la digue.

11- Contrôle :

  • Retoucher la préparation si c’est un faux moignon
  • Contrôler l’occlusion à l’aide d’un papier d’articulé ;
  • Retoucher à l’aide
    • Les fraises diamantées bagues jaunes permettent de retoucher les faces occlusales et vestibulaires de dents postérieures ainsi que les faces palatines des dents antérieures.
    • Les disques à polir sont utilisés pour les faces vestibilaires des dents antérieures.
    • Le strip à polir permet de polir les faces proximales.

Actes associés


Administration

Dossier

Information

  • Intitulé et description de l’acte.
  • Teinte.
  • Longueur du tenon
  • Difficultés rencontrées.
  • Validation du responsable de la vacation.

Cotation

  • Cotation et derrière le code service.
    • 9042 OCE
      • SC 33
    • 9043 Radio CSD
      • Z4 +x ou x est le nombre de radios suivantes
  • Validation du responsable de la vacation.

Q-planner

  • Convenir avec le patient de la date et l’heure de la séance de soin suivante.
  • Rentrer la séance de soin suivante dans Q-planner.

Informations

  • Diffusion par le pôle ondontologie.
  • Processus : Réalisation du programme de prise en charge du patient.
  • Domaine d’application.
    • Pôle ondontologie.
    • Étudiants de la faculté de chirurgie dentaire de Nantes.
  • Rédacteur : Thomas Weigel/Gregory Devilliers.
  • Vérificateur : Dr A. Gaudin
  • Approbateur : Pr O. Laboux.
  • Date d’application : 00/00/0000.
  • Version : 1.
  • Bibliographie
    • Cours de la faculté de chirurgie dentaire de Nantes.
      • ODONTOLOGIE CONSERVATRICE ENDODONTIE : 58ème Section - 1ère Sous-Section.
    • Cahiers de travaux pratiques de la faculté de chirurgie dentaire de Nantes.
      • ODONTOLOGIE CONSERVATRICE ENDODONTIE : 58ème Section - 1ère Sous-Section.
    • Roulet JF, Degrange M.
      • Collages et Adhésion. La révolution silencieuse.
      • Quintessence International ,2000.

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