The continuous development of bulk restorative materials has significantly contributed to simplifying restorative procedures while maintaining long-term clinical success. These materials allow clinicians to achieve predictable, durable, and aesthetic outcomes with reduced chair time.
The present clinical case describes the management of a young patient (34 years old) presenting with multiple carious lesions in the first quadrant, all successfully treated in a single appointment within a limited clinical time. The use of simplified restorative strategies, including bulk-fill materials and modeling technique such as the Espresso Posterior Technique, enabled efficient reconstruction with optimal functional and aesthetic results.
This article demonstrates how a full quadrant can be efficiently restored in a single session using simplified, biologically driven restorative approaches.
Fig.1
Initial clinical situation. The first quadrant presented multiple carious lesions and infiltrated, aged composite restorations. In accordance with the patient’s needs, all restorative procedures were planned and performed in a single clinical session.
Fig.2
Rubber dam isolation before restorative procedures.
Fig.3
Before caries removal, two wedges were placed to isolate and protect the deep cervical margins. The Class II cavities exhibited very deep carious lesions.
Fig.4
Initial caries excavation. Areas of infected dentin were still evident; therefore, a caries detector was applied to identify regions requiring further removal.
Fig.5
Caries detector highlighting areas of residual infected dentin requiring further removal.
Fig.6
Current literature reports differing approaches to caries removal, ranging from complete excavation to selective dentin preservation. In the present case, caries removal was performed until hard dentin was obtained to allow reliable adhesion.
Fig.7
Correct positioning of sectional matrices and separation rings to ensure proximal contour and contact.
Fig.8
Selective enamel etching performed for 20 s prior to adhesive application.
Fig.9
Class II cavities were converted into Class I cavities by sealing the dentin with a bulk-fill flowable composite (SimpliShade Bulk Fill Flow, Kerr), while the proximal walls were reconstructed using a high-viscosity bulk-fill composite (SimpliShade Bulk Fill, Kerr).
Fig.10
Final restoration performed with the same bulk-fill composite, with occlusal anatomy modeled using the Espresso Posterior Technique.
Fig.11
Final characterization performed using Kolor Plus Brown (Kerr) to enhance the three-dimensional appearance of the restorations.
Fig.12
Polishing step performed using rubber polishers.
Fig.13
Final outcome. After rubber dam removal, occlusal contacts were checked and confirmed.
Fig.14
One-month follow-up demonstrating absence of postoperative sensitivity and stable direct restorations, maintaining proper function and favorable aesthetic integration.
Conclusions
Modern bulk-fill composite resins enabled efficient cavity filling with reduced risk of air entrapment and void formation, while ensuring satisfactory aesthetic integration.
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