Wait the Rehydration

Community - Direct anteriors
26 Oct 2016

Proximal caries in anterior teeth is big challenges to dentist because it's in esthetic zone , SO the shade selection should be accomplished prior to rubber dam isolation to prevent improper color matching that may result from dehydration and elevated values.

Fig. 1

Img.1 – frontal view in occlusion showing the proximal carious lesion in multiple teeth .

Fig. 2

Img.2 – palatal view showing the carious lesion more clearly .

Fig. 3

Img.3 – frontal view showing the proximal carious lesion in four anterior teeth .

Fig. 4

Img.4 – isolation in such case is mandatory to be work in clean field .

Fig. 5

Img.5 – isolation provide more visible area to the target ( the field is ready to work on ) .

Fig. 6

Img.6 – another view with further magnification .

Fig. 7

Img.7 – frontal view after removing the caries .

Fig. 8

Img.8 – palatal view showing the cavities after caries removing .

Fig. 9

Img.9 – another view showing the cervical enamel free from caries and clean .

Fig. 10

Img.10 – total etching with 37% phosphoric acid .

Fig. 11

Img.11 – sectional celluloid strip with emergency profile and fixed by wedge .

Fig. 12

Img.12 – bonding the cavities with vigorous brushing . 

Fig. 13

Img.13 – light curing .

Fig. 14

Img.14 – palatal view before finishing and polishing . 

Fig. 15

Img.15 – frontal view immediately after finishing .

Fig. 16

Img.16 – the filling is marked , don't worry , wait the rehydration.

Fig. 17

Img.17 – frontal view after removing the rubber dam .

Fig. 18

Img.18 – palatal view after removing the rubber dam .

Fig. 19

Img.19 – frontal view showing the rehydration and matching the color after one month control .

Fig. 20

Img.20 – palatal view after rehydration ( one month control ). 

Fig. 21

Img.21 – frontal view showing the result after rehydration and color matching .

Fig. 22

Img.22 – Before and After .

 

Conclusions

When the teeth dehydrate , the air replaces the water between the enamel rods , changing the refractive index that makes the enamel appear opaque and white .
If the correct shade color is selected before isolation with rubber dam , don’t worry , just trust to rehydration .

Bibliography

References
1 . Hall NR, Kafalias MC. Composite colour matching: The devel- opment and evaluation of a restorative colour matching system. ?Aust Prosthodont J 1991;5:47-52. ?
2 . Winter R. Visualizing the natural dentition. J Esthet Dent 1993; ?5(3):102-117. ?
3 . Devoto W, Saracinelli M, Manauta J. Composite in everyday practice: how to choose the right material and simplify application techniques in anterior teeth. EJED 2010, vol.5, No.1, 102–124.
4 . www.styleitaliano.org/ cervical enamel-Jordi Manauta
5 . www.styleitaliano.org/ Tips and Tricks for proximal caries in anteriors-Mohamed Salah