Intracuring; Intrastromal Intracuring; Intrastromal Corneal Application of Corneal Application of

Dental Flowable CompositeDental Flowable Composite

Faik Oruçoğlu (Orucov)Faik Oruçoğlu (Orucov)

Istanbul / TurkeyIstanbul / Turkey

ECC 2010ECC 2010

The author do not have any proprietary interest in the products and drugs mentioned in this presentation. Dr. Oruçoğlu (Orucov) hold patents to the Intracuring method for cornea flattening with intrastromal corneal application of dental flowable composite.

A dental restorative or dental filling is A dental restorative or dental filling is a a dental restorative materialdental restorative material used to used to restore the functional integrity and restore the functional integrity and morphologymorphology of missing tooth of missing tooth structure. structure.

flowable composites are more flowable composites are more frequently applied because of their frequently applied because of their flowability and easy handling of the flowability and easy handling of the applicator since 1996.applicator since 1996.

Flowable restoratives are low Flowable restoratives are low viscosity, visible light-cured, viscosity, visible light-cured, radiopaque materials that are radiopaque materials that are indicated for a variety of uses, indicated for a variety of uses, including direct restorative pit and including direct restorative pit and fissure sealant, repair of indirect fissure sealant, repair of indirect composite porcelain and temporary composite porcelain and temporary acrylic materials.acrylic materials.

Flowability allows the material Flowability allows the material to be injected through small-to be injected through small-gage dispensers thus gage dispensers thus simplifying the placement simplifying the placement procedure and amplifying the procedure and amplifying the range of clinical applications .range of clinical applications .

The flowable composites can The flowable composites can be easily inserted into small be easily inserted into small cavities and are expected to cavities and are expected to exhibit better adaptation to the exhibit better adaptation to the internal cavity wall compared internal cavity wall compared to the conventional restorative to the conventional restorative composites.composites.

We hypothesized that flowable dental composites could We hypothesized that flowable dental composites could be used in the cornea for the same indications as ICRS be used in the cornea for the same indications as ICRS for flattening the corneal curvature.for flattening the corneal curvature.

We called this intrastromal polymerization technique We called this intrastromal polymerization technique ‘intracuring’ procedure. ‘intracuring’ procedure.

In this study, dental flowable composites were used In this study, dental flowable composites were used intrastromally in sheep corneas for the purpose of intrastromally in sheep corneas for the purpose of flattening the anterior corneal curvature. flattening the anterior corneal curvature.

This is the first experimental study of intrastromal This is the first experimental study of intrastromal polymerization in changing anterior corneal curvature.polymerization in changing anterior corneal curvature.

MethodsMethods In an experimental laboratory set up eight fresh In an experimental laboratory set up eight fresh

sheep eyes were used for tunnel creation. sheep eyes were used for tunnel creation. Before the procedure the corneal epithelium Before the procedure the corneal epithelium

was removed with a corneal scraper in all eyes was removed with a corneal scraper in all eyes to have consistently smooth corneal surfaces.to have consistently smooth corneal surfaces.

Afterward, the eyes were fixed in an interface, Afterward, the eyes were fixed in an interface, positioned, and attached by applying suction positioned, and attached by applying suction energy to the Femtec laser system energy to the Femtec laser system

The laser settings were as follows: tunnel depth The laser settings were as follows: tunnel depth in 450 µ; inner diameter 6.6 mm; outer diameter in 450 µ; inner diameter 6.6 mm; outer diameter 8.8 mm; entry cut length 0,8 mm. The incision 8.8 mm; entry cut length 0,8 mm. The incision was placed at 12 oclock. was placed at 12 oclock.

After completion of the laser cut, flowable After completion of the laser cut, flowable composite was injected slowly through the composite was injected slowly through the tunnel incision until complete filling. tunnel incision until complete filling.

Excessive composite was cleaned from Excessive composite was cleaned from the incision. the incision.

Flat plastic material was used for pressure Flat plastic material was used for pressure on the cornea during polymerization. An on the cornea during polymerization. An LED light was applied for polymerization LED light was applied for polymerization for 20 seconds. for 20 seconds.

ResultsResults

The change on the cornea curvature was The change on the cornea curvature was observed in the all cadaveric sheep eyes after observed in the all cadaveric sheep eyes after intracuring intrastromal polymerization. intracuring intrastromal polymerization.

Scheimpflug images showed significant changes Scheimpflug images showed significant changes on the corneal curvature.on the corneal curvature.

Therefore, as sheep corneas are flat, more Therefore, as sheep corneas are flat, more flattening was achieved by the intrastromal flattening was achieved by the intrastromal polymerization of flowable composites.polymerization of flowable composites.

Flattening in the inferior cornea and steepening Flattening in the inferior cornea and steepening at the opposite part was seen on the sagittal at the opposite part was seen on the sagittal curvature mapcurvature map

ConclusionConclusion

This new application may be a promising This new application may be a promising technique for the treatment of keratoconus technique for the treatment of keratoconus or myopia.or myopia.

The application of this technique in The application of this technique in humans could offer improved treatment humans could offer improved treatment options in the futureoptions in the future

The clinical applications and safety of The clinical applications and safety of these materials in human corneas require these materials in human corneas require further study.further study.