Dentaltown November 2020 - 54

Fig. 21

Fig. 23
Fig. 25

Fig. 22

Fig. 24
Fig. 26

greater structural integrity.25 When fibers are
placed on a restoration's occlusal surface from
a buccal to lingual direction, significantly
higher fracture resistance is observed. 26
Microtensile bond strength increases the
dentin in cavities with high C factor.27 It is
crucial to leave the restoration with sufficient
strength to survive occlusal stress, particularly
if the restoration is subjected to the same
forces that initiated the original failure.28
The data indicates that composite resin
is a technique-sensitive restorative material
that can be used in large preparations,
if proper manipulation and isolation are
maintained.29 As oral health providers, we
are always looking for the best treatment
modalities for our patients.30

Conclusion
Once cracks are detected in an early state,
an immediate direct reinforced restoration
would provide protection and could save
many teeth. If the tooth with a crack is left
without treatment, a bacterial penetration
could form, resulting in inflammation and
disease. Ribbond fibers bridge the cracks
that are commonly seen in the pulpal floor
of old amalgams and resin restorations. The
fibers act as a staple, holding both sides of
the crack together. By adapting the fibers
closely to the dentin, the clinician can

54

increase tooth toughness and prevent the
existing dentin crack from propagating and
failure. Direct adhesive restorations require
a lot of attention to detail. ■

References
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13.

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Mamoun, J.S., and Napoletano, D. "Cracked Tooth Diagnosis and Treatment. An Alternative Paradigm." European
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March 2008: 16-20.
Opdam, N.J., Bronkhorst, E.M., Loomans, B.A., and Husymans, M.C. "12-Year Survival of Composite vs. Amalgam
Restorations." J Dent Rest. 2010 Oct; 89(10):1063-7.
Chyz, G., "Restoration of an 'At Risk' Tooth, Replacing an
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Barghi, N., Knight, G.T., and Berry, T.G. "Comparing
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Sorensen, J.A., and Mito, W.T. "Rationale and Clinical
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Dent Technol 1998; 21: 81-90.
Walls, A.W., McCabe, J.F., and Murray, J.J. "The Polymerization Contraction of Visible Light Composite Resins." J
Dent 1988; 16 177-181.
Van Meerbeek Special Report for the October 2014 issue of
Compendium Adhesive Dentistry: 2013 fi fth International

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