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Bevel

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mohamed abouelnaga

on 7 October 2013

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Transcript of Bevel

Introduction
Definitions
Types of Bevels
Conventional

-45 degrees

-0.5 mm long

-0.5 mm thick

Whats your Final Conclusion?
Beveling in Posterior Class I and class II cavities
Egypt
- 1,010,000 square kilometers
- Egypt is one of the most
populous countries in Africa
and the Middle East, and the
15th most populated in the
world.

Cities of Egypt
-27 Governorates
-Cairo,Alexandria,
Sharm Al Sheikh
and Aswan are
the Main Ones.
Cairo
Alexandria
Cairo University
-The university was founded on December 21, 1908
-Several constituent colleges preceded the establishment of the university including the College of Engineering in 1816
- In 1925, the faculty was founded under the name of School of Dental Medicine
Cairo
Tahrir Square
- 82 Million People
-Egypt has one of the longest histories of any modern state, having been continuously inhabited since the 10th millennium BCE.
Cavo-surface angle:
Bevel :
S. Bouillaguet et al 2006
Cavities Classification by G.V Black (Father of Operative Dentistry)
Class I :
Class II :
Cavities Classification by G.V Black (Father of Operative Dentistry)
Bevels with Different Posterior Restorations
Amalgam : NO
Composite : ???? What do you think??
Glass Ionomers : No
- Any angle other than 90 degrees
between a tooth cut and a cavity wall
in the preparation of a tooth cavity.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
Types of Bevels
Retentive

-60 degrees

-1-1.5 mm long

-1-1.5 mm thick
Types Of Bevels
Esthetic (Long Bevel)

-60+ degrees

-2+ mm long

-1.5mm thick
Types Of Bevels
Functional Cusp Bevel
Chamfer Bevel (Round Bevel)
Types of Bevels According to site.
External Bevel

- Beveling of the external line angles of the cavity and external tooth structure.
Advantages of Beveling
The angle formed by the Junction of a cavity wall and an external tooth surface.
Summit Book , 3rd edition
Lesions that occurs in pits and fissures on the facial, lingual, Occlusal surfaces of Molars and premolars and less often the lingual surfaces of maxillary anterior teeth.
Summit Book, 3rd Edition
Lesions Occuring on the Proximal surfaces of posterior teeth.
Summit Book, 3rd Edition
- Additional 0.5 mm Bevel at functional cusps in crown preparations to give sufficient space for material to withstand high occlusal forces.
- Rounding the cavo-surface angle.
Coelho-De-Souza,Braz Dent J, 2010
Kinomoto et al, American Journal of Dentistry, 2003
Types of Bevels According to site.
Internal Bevel

- Beveling of Internal line angles of a cavity.
Kinomoto et al, American Journal of Dentistry, 2003
- Increase exposure of the ends of Enamel Prisms
Coelho De Souza,J Appl Oral Sci, 2010
- Increase surface area of bonding
- Increase stregnth of Adhesion
Coelho De Souza,J Adhes Dent, 2008
Advantages of Beveling
Advantages of Beveling
Advantages of Beveling
Coelho-De-Souza, J Appl Oral Sci, 2010
- Increase Resistance to fracture of restored teeth
Coelho De Souza, Dent, 2008
- Reduce Microleakage and Improve the marginal seal
Advantages of Beveling
- Better Color blending and esthetic results
- Masking the interface between enamel and composite
Coelho-De-Souza, J Appl Oral Sci, 2010
- Increase the unbonded surface area of the restoration (Decrease the C-Factor) which leads to reduced contraction stresses in these restorations
Disadvantages of Bevels
- The additional removal of sound tooth structure
- Enlargement of the tooth preparation, unless unsupported enamel is preserved
Coelho-De-Souza et al appl Oral Sci, 2010
M. Opdam,Pros Dent, 1998
Disadvantages of Bevels
- Tooth preparation of a bevel is arduous in small cavity Preparations when proximal margins are in contact with the adjacent tooth
M.Opdam, J Pros Dent, 1998
Disadvantages of Bevels
- In extensive loss of tooth structure , tooth preparation of a bevel at a cervical margin may result in removal of remaining enamel
M.Opdam, J Pros Dent, 1998
Disadvantages of Bevels
- Bevels thin out the restoration
at margins
Lienberg, Quintessence international, 2000
- Contra-indicated in high occlusal force areas ( occlusal contacts)
Group Discussion Article ( Clinical case)
The Axial bevel technique: A new technique for extensive posterior resin composite restorations.
Lienberg, Quintessence international, 2000
Discussion of Articles
Article: Polymerization contraction stresses of resin-based composite restorations within beveled cavity preparations of class I restorations.
Mohamed Ahmed Abou El Naga
Results
Article : A randomized double-blind clinical trial of posterior composite restorations with or without bevel : 1-Year follow-up.
Coelho-De-Souza, J Appl Oral Sci, 2010
Mohammad AlRefeai
Conclusion
Article : Influence of adhesive system and bevel preparation on fracture strength of teeth restored with composite resin.
Coelho-De-Souza, Braz Dent J, 2010
Rawa Alammari
Conclusion
Article: Necessity of bevels for box only class II composite restorations.
M.Opdam, J Pros Dent, 1998
Lamya Alghaith
Conclusion
Time to Relax!!!
Kinomoto et al, American J Dent, 2003


- Evaluating the internal stresses that result from polymerization of composites in cavity preparations beveled internally or at the cavo-surface angle, comparing results with butt joint box shaped cavities
- Palfique clear transparent composite resin was used to restore class I cavities made in a composite model
Materials and methods
Prep 1 : 1 mm depth with bevels at internal line angles. (how??)
Prep 2 : 2mm in depth with bevels at internal line angles. (how??)
Prep 3 : 2mm in depth with rounded bevels at the cavo-surface margins.
- All cavities were 5 mm in length and 2mm width.
- Each restoration was light cured for 80 seconds using a quick light VL-1d
- Placed in water for 30 minutes
- Light cure intensity was 400 mW/cm2. Diameter of light cure tip was 5mm
- Specimens were prepared for Photoelastic analysis by cutting 2mm thick sections perpendicular to the long axis of the preparation
- stress lines were almost parallel to cavity walls at internal bevels in preps 1 and 2.
- In the butt joint prep (Which prep is this one ??) , stress lines were 45 degrees to both lateral walls and preparation floor. Stresses were high.
- In prep 3 : there weren't any difference in stress lines between the beveled cavosurface margin and butt joint ones !!
Conclusion
- Contraction stresses of resin based composites were decreased in class I cavities with internal bevels.
- Beveling the cavosurface margins had little effect on the contraction stresses of resin based composites.
- All restorations were acceptable after one year.
- No change in properties was observed when beveled and non-beveled restorations were compared except for marginal staining. (lower in beveled preps)
- What are the causes of staining ?

- leakage, material defects, surface roughness, type of bonding ......

think what else??
Clinical case comments
Step 5 : A wrap around bevel was prepared without water coolant for visualization !!
- A tapered Diamond bur was used to bevel the walls all around
step 7 : The matrix assembly was completed before etching to exclude any contamination especially from gingival crevicular fluid !!
Step 13 : Successive cuspal technique, Do any one of us use this technique ? Is it beneficial to use it ?
- "Low Intensity polymerization of each cusp is done individually, and the catalytic reaction continues while the next cusp is being sculped into the appropriate form. The next dose of low intensity light will include the preceding cusps, and cumulative polymerization exposure will improve the overall interfacial integrity"
Comment !!!
Step 14 : "The anatomically contoured matrix is reflected against the proximal surface of the adjacent tooth. the matrix will now serve as a guiding and protective scaffold during finishing with Discs."
The advantage of the wrap around bevel :
1- Increase surface area of bonding and bond strength.

2- Provide a wrap around support for the weakened enamel prisms.
- It is crucial to record the pre-operative occlusal contact areas in centric and functional excursions.

- Ensure that contacts are kept away from the restorative material and bevel.

- If the bevel will remove a natural tooth contact area so the occlusal bevel will be contra-indicated.
Article: Split mouth randomized controlled clinical trial of beveled cavity preparations in primary molars: an 18 month follow-up.
Paula Ortega
Conclusion
Article: Fracture resistance and gap formation of MOD restorations: Influence of restorative technique, bevel preparation and water storage.
Coelho-De-Souza,Op Dent, 2008
Carolina Garcia
Conclusion
- All restored teeth showed success within the 24 hour period.
- R?istance to fracture was increased by using Total etch adhesive with bevel. (Article conclusion)
- Beveling of small box type class II composite restorations is recommended for an optimal marginal seal
- Beveling of the Cervical, Facial and lingual margins gave the best results in reducing microleakage
- Beveling the teeth was done by doing a chamfer all over the cavo-surface margins.
- The adhesive system had a stronger effect on results rather did the bevel. we can't say that beveling decreased the marginal leakage depending on the results the author got. (My conclusion).

- Do you have the same conclusion ?
Oliviera, J Dent, 2008
Conclusion
- Beveling of teeth were made along all cavo-surface margins.
- "Beveling resulted in improved fracture resistance and marginal adaptation, reducing the impact of long term storage on restoration quality.'
Thanks
Thanks
Dr. Denehy
Dr. Cobb
Materials Used For preparing the presentation
- 3 Books
- 7 Articles
- 67 Pictures
- 1 VIDEO

M.Abouelnaga

Cairo Tower
Conclusion
- Does the conclusion make sense ?
Dr. Maia
The pyramids
The Alexandrian Library
Alexandria Qaitbay Fortress
Winter in Alexandria
Types Of Bevels
M.Abouelnaga
Non-beveled direct composite restoration after 180 days exhibiting a marginal gap in the cervical wall.
Beveled direct composite restoration exhibiting gap-free cervical margin after 180 days.
M.Abouelnaga
- Beveling margins didn't improve the success of primary molars over 18 months period
Final Conclusion
- Four Articles stated that beveling increased success rates of restorations and two articles stated the opposite.
-I assume that they beveled all external and internal margins.
Which margins were beveled ???
Purpose of the study
Materials and Methods
- Split mouth, double blinded, randomized controlled study.
- Evaluate the clinical performance of composite in class I beveled margin cavity preparations in primary molars.
- Ninety four cavity preparations were prepared
- Thirty two molars were carious
- children were aged 4-10 years
- Group 1 : Conventional conservative preparation.
- Group 2 : Modified preparation with cavo-surface bevel. ( 45 Degree bevel, 0.5mm)
- Bonded with Prime and Bond 2.1 Dentsply and used TPH Spectrum Dentsply composite
- Composite was polymerized in increments for 40 Seconds ( each increment?? how many increments??
- Halogen light of 500 Wm/cm2
- Evaluation of restorations were done by the visible plaque index and the fiber optic transilumination (FOTI)
- Evaluation was done within 6, 12 and 18 months period
Results
- Seventy six restorations were considered as clinically successful after 18 months.
- Looking at tables one and two, we will notice that beveling didn't increase the success of restorations.
- Conventional Beveling of tooth was made by Diamond bur. Didn't mention exactly which surfaces or margins were beveled !!
- Most articles didn't mention exactly which margins should be beveled ( I assumed that they beveled all margins as they didn't state the opposite)
Final Conclusion
Beveling of all margins in posterior class I and II cavities will improve the success of composite resin restorations
Purpose of the study
Full transcript