Wedge-shaped defect is a kind of defect formed by the slow consumption of hard tissue in the neck of teeth, which is V-shaped. Because its shape is similar to the wedge used by carpenters, it is called wedge-shaped defect. Most of them were found on the labial surface of anterior teeth or bicuspid teeth, most of them were middle-aged and old patients.
The characteristic of wedge-shaped defect filling is that the part near the gingival margin or the cavity margin is located under the gingiva, so the pollution of gingival crevicular fluid should be avoided during filling.
The key points of operation are as follows: gingival drainage is required after the preparation of the hole edge slope. It is suggested to stack plastic resin from "occlusion" to "gingiva" during the layered filling to avoid the surface of bonding / resin being polluted by gingival crevicular fluid during the filling process. The whole acid etching dentin, enamel bonding and resin filling process: cavity preparation → color comparison and color selection → cleaning cavity and moisture separation, the adjacent cavity type must use forming sheet and wedge → pulp protection (calcium hydroxide, glass ion, etc.) → acid etching for 15 seconds → thorough washing (Note: do not let the patient rinse) → air gun blowing or cotton suction to keep the tooth surface moist → Wait 15-20 seconds for adhesive coating → blow gently for 5 seconds → the tooth surface presents a bright layer (if not, recoat it; if it is self etching adhesive, first coat it for 15 seconds, and then coat it again) → light for 10-20 seconds → layered filling composite resin (if it is necessary to block color, first use color blocking resin), layer by layer curing for 20 seconds, if it is necessary to block color, it will take 40 seconds to complete filling → Trim the shape (note that the adjacent surface can not form overhang and the edge is smooth) → adjust the occlusion → polish and polish → instruct the postoperative precautions.
① Cavity preparation: keep healthy tooth tissue as much as possible, with low requirements for cavity shape, and appropriate retention of non base glaze; pay attention to the use of flame shaped needle to prepare the hole edge slope. ② Color comparison and color selection: the color comparison of anterior teeth in cosmetic repair was conducted according to dentin, enamel and transparent layer of cut end, and the corresponding functional resin was selected.
③ Clean the cavity and keep away from dampness. It is recommended to use rubber barrier. Do not let the patient spit during the operation. ④ Acid etching: the time should be strictly controlled, from enamel to essence, and thoroughly washed. ⑤ Control of tooth surface wettability: do not over wet or over dry. If acetone based adhesive is used, it is more sensitive to tooth surface wettability, just slightly dry.
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