Direct composite restorations’ function and aesthetics

A clinical case by our Community member Dr Nasim Akhatov

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

Class II proximal restorations require to fulfil several challenging in the daily clinical practice. The main task to achieve is an anatomically correct contour with a sealed contact zone. Adding to the challenge for creating the aesthetic tooth shape according to the nature. The aim of the present article is to emphasize the importance of restoring the posterior direct regions with a fast technique.

style italiano styleitaliano initial situation direct posterior composite restoration

Fig.1
The premolars (24 and 25) presented a failed restoration that needs to be replaced with a new one due to a violation of the boundary seal. In addition, the patient complains of the sensitivity to thermal and chemical irritant. Tooth 26 was previously restored.

style italiano styleitaliano Isolation, cavity preparation, and bonding

Fig.2
After isolation of the working field, the cavity of the tooth 25 was prepared. It is very important to create a proper design of the prepared mold for better matrix system adaptation.
The tooth cavity was prepared by sandblasting with 29 microns aluminium oxide before the application of the etching and the adhesive. Next, Curing Pen By Eighteeth was used to polymerize the adhesive.

curing pen light style italiano styleitaliano eighteeth
curing pen light style italiano styleitaliano eighteeth
style italiano styleitaliano Proximal walls creation of the tooth 25

Fig.3
After matrix system adaptation, the proximal contacts of tooth 25 were restored with a conventional composite and a 2 mm thick bulk-fill resin composite was applied to the bottom of the class I cavity.

style italiano styleitaliano Tooth 25 bulk fill restored

Fig.4
Final situation after tooth 25 anatomical structure restoration.

style italiano styleitaliano Restoration of the tooth 24

Fig.5
Starting the restoration of the tooth 24.

style italiano styleitaliano Separation of the tooth 24

Fig.6
It is very important to isolate the tooth 24 before preparation so that the bur does not hit the proximal surface of the tooth 25. In this situation, a separation wedge was used.

style italiano styleitaliano Adaptation of the matrix

Fig.7
Correct adaptation of the matrix and the ring is the key to the success of the contact point. Proximal surface restoration of the tooth 24 becomes much easier when a correct shape of the neighboring tooth medial wall is available.

style italiano styleitaliano final view of the restoration

Fig.8
Final view of the restoration before grinding and polishing (tooth 24 was filled like tooth 25).

style italiano styleitaliano Polishing steps

Fig.9
Finishing and polishing steps for the restoration of the tooth 24 and the tooth 25.

style italiano styleitaliano final situation resin composite restoration

Fig.10
The glossy surface of the restorations indicated the correct use of polishing agents and materials.

style italiano styleitaliano Comparison between the before and after resin composite restoration

Fig.11
Before and after. The final situation after isolation system removal showed the good integration of the material and the technique used for restoring this kind of cavity.Teeth 24,25,26 were restored taking into account the function and aesthetics of these tooth groups.

Conclusions

An important task for the dentist is to create a long-lasting restoration with minimal tissue loss and a very simple technique that can be easily repeated in daily practice.

Bibliography

  1. Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub.
  2. Hardan L, Sidawi L, Akhundov M, Bourgi R, Ghaleb M, Dabbagh S, Sokolowski K, Suarez C, Szymanska M. One-Year Clinical Performance of the Fast-Modelling Bulk Technique and Composite-Up Layering Technique in Class I Cavities. Polymers 2021;13:1873.
  3. Marchetti G. 10 TIPS on Posterior direct restoration in daily flow. 2018. Styleitaliano.org.
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