A clinical case by our Community member Dr Muhammed Bahadeen
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Anterior teeth presented with extensive class III carious lesion can be a challenge to restore since the clinician have to deal with different refractive indices of enamel and composite, and blend them well so that there will be no evidence of any refraction and grey line appearance. The article presented a step by step protocol for class III carious lesions.
The patient comes to the clinic with multiple class III carious lesions. An initial photograph is crucial to show the patient the evolution of the treatment.
The lesion has extended labially and undermined the enamel.
Simple button technique for shade selection was applied here for enamel and dentin shade.
The isolation of the teeth was performed after shade selection.
After caries removal, a peripheral seal zone must be seen and cleaned all around the remaining caries near the pulp to avoid exposure and keep the vitality of the pulp.
Then, the dentin was disinfected with chlorhexidine.
On the labial surface, after removing all the unsupported enamel, the surface should be beveled and exposed with some dentin so it can be blended with the dentin composite shade and later on with the enamel shade.
The palatal shell was created using translucent enamel.
The translucent enamel shade resembles the natural enamel shade optically.
Proximal wall is also created using enamel shade and now it is ready to receive dentin shade.
Dentin shade is placed and blended with the bevel.
Enamel shade is placed above the dentin shade and blended with the bevel.
Same procedure was performed on the lateral incisor and the rest of the teeth.
Prior to more fishing and polishing.
Class III restorations can be quite difficult since the clinician have to choose the shade perfectly and have to follow good protocols. This is important to avoid grey line formation due to different refractive indices of enamel and composite material. Plus, the composite material thickness control is essential for that matter.
- Manauta J, Salat A. Layers, An atlas of composite resin stratification. Quintessence Publishing Co; 2012.