Composite modeling using ultra-thin spatulas
For perfection in aesthetic restorations we need a precise modeling, right color selection and good shapes. In order to model the composite precisely it is suggested to have the right instruments. In the market we can find plenty of suitable instruments for composite stratification. In some of the modeling instruments for composite kits we can find a very thin spatulas. Thin spatula is convenient for precisely modeling the composite. Not all the kits have thin spatula maybe because it is a delicate instrument, but the disadvantages outweigh the advantages in the opinion of most of the experts in composite.
Inside the LM arte kit (LM instruments, Finland) it is possible to find a thin spatula, thinner than many others in the market. In this article we wanted to point out the advantages of modeling with a thin spatula like Applica (the thin spatula from the LM arte kit) whilst presenting anterior free hand restorations for a change of smile of a patient after orthodontics. The instrument has an Italian name (Applica), but the name is internationally understood because it is similar to the english word apply, which is related to its function which is applying composite.
The Styleitaliano group pushes the high quality dentistry with feasible, repeatable protocols, moderate costs for the patient, avoiding over-treatments and controlling the chair time. The free hand single visit smile rehabilitation with a single mass is a good example of that philosophy. In this particular case we demonstrate how choosing the right material, specially choosing the right opacity of the material, with a precise modeling of composite and giving the right shapes, in a single visit and a unique color, the aesthetic results can be more than acceptable for the patient and for us.
The images in this article were extracted from a 4k video shot over the shoulder, during the Layers live course at Dentcof, Timisoara. Thanks to Dr. Florin Cofar and Migai Simonia for the chairside shooting of the video. I would also like to thank Walter Devoto and Angelo Putignano for pushing me to use the single appointment and single shade approach as it is, in most situations, the preferred approach for my patients. Also thanks to LM Dental, Finland, for creating this thin spatula, as its production required special research and technology.
THIN SPATULA ADVANTAGE no. 1
It allows the practitioner to be precise when modeling the proximal wall either in posteriors or in anteriors. Specially in small diastema like the one from the picture, the reduced thickness of the thin spatula allows the practitioner to enter in the interproximal space giving the precise shape to the interproximal wall. So it enables the modeling in narrow spaces and even penetrating them from side to side.
Adapting the composite in the cervical area is almost impossible to do if it is not with a thin and small spatula.
Modeling the inter-incisal angle is also easier with the thin spatula. It is possible to insert the thin spatula in small spaces as you can see in the picture, the same concept that when modeling the inter-proximal wall.
Modeling precisely the incisal edge. Even if there is plenty of space and the incisal edge could be performed with any conventional spatula, thanks that instrument Applica (LM Arte kit) is very elastic, it allows the practitioner to be subtle and feel the pressure applied when adapting composite to the tooth.
It can be used to gently smoothen the composite with more precision as the touch sensation increases.
The single visit appointment with composites when changing a smile is convenient and economic compared to ceramic approach. As it is a reversible procedure we can always modify, repair or reshape easily directly in the mouth of the patient and if in a future the patient wants ceramic veneers the composites are not an inconvenient. The single mass approach allows us to perform multiple case restorations with moderate time letting us focus on the modeling and shaping. Modeling composite with the right instruments is important. The thin spatula like the Applica from the LM-Arte kit (from LM, Finland) is mandatory to adapt the composite in narrow spaces like in this case. Once you get used to use a thin and delicate instrument you would probably use it in each situation. Special attention from all the dental team is required for the maintenance of this spatula as it is thin and delicate. A delicate instrument should be treated delicately and we should explain it to our nurses and the staff in charge of cleaning the equipment.
Although more elaborate composite layering techniques exist and may be used in some esthetic scenarios, a simplified approach with a right color and opacity single shade and implementing basic dental anatomy concepts often will deliver highly acceptable esthetic results. You can also find single shade anterior restorations with esthetic results in this article published by Jordi Manauta.
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