Fast daily posterior restorations

A clinical case by our Community member Dr. Ali Almasoudi

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.

Making fillings fast and easy is nowadays possible also thanks to bulk composite materials. Faster modeling techniques, such as the Essential Lines technique (by Giuseppe Chiodera) and the Fast-modelling Bulk Technique (by Louis Hardan and Murad Akhundov) were introduced to save time in daily restorative sessions.

styleitaliano style italiano old infiltrated amalgam restoration

Fig.1
Initial situation of an old infiltrated restoration.

styleitaliano style italiano preliminary occlusal check

Fig.2
The initial occlusal check was made using a 40 micron articulating paper. This stage is made to help the dental clinician to see the contact points in order to prepare and restore properly.

styleitaliano style italiano cleaning a cavity on lower molar

Fig.3
After rubber dam isolation, we started by removing the old restoration and the carious tissue.

styleitaliano style italiano clean cavity isolated with rubber dam

Fig.4
After the old materials and carious tissue were removed, the cavity was refined and sandblasted with 27-micron aluminum oxide particles.

styleitaliano style italiano matrix wedge and ring ready for class II cavity restoration

Fig.5
After placing the matrix and wedge, a ring was used to improve adaptation of the matrix to the proximal walls. The bulk composite resin was used to build the proximal wall, and to obtain a simple class I cavity to fill.

styleitaliano style italiano proximal build up in class II filling

Fig.6
After modeling the proximal wall the matrix is removed, without removing the wedge. The contact point will be strong as we want it to be.

styleitaliano style italiano layering in posterior deep cavity

Fig.7
A flowable layer is excellent to make the bottom of the cavity more regular.

styleitaliano style italiano raw bulk composite before modeling

Fig.8
The bulk restorative material (Filtek™ One Bulk Fill Restorative, 3M) can be placed in one increment and packed using the Condensa instrument (LM Arte powered by Styleitaliano) on the entire occlusal area.

style italiano styleitaliano 3m filtek one composite
style italiano styleitaliano 3m filtek one composite
styleitaliano style italiano fast modelling technique with bulk composite

Fig.9
Following the residual anatomy of the tooth, fissures can be marked using the Fissura instrument (LM Arte kit powered by Styleitaliano). Two minutes are usually enough to model the entire occlusal anatomy when using the Fast Modelling Technique (FMT).

LM ARTE kit posterior banner desk style italiano styleitaliano
LM ARTE kit posterior banner mobile style italiano styleitaliano
styleitaliano style italiano composite restoration on lower molar with stained sulci

Fig.10
The occlusal anatomy was restored, with a beautiful natural appearance. Some tint was added to enhance the appearance of the restorations and the fissures.

styleitaliano style italiano occlusal check of composite restoration

Fig.11
Occlusion check. Minimal adjustments were needed, the anatomy was not influenced.

styleitaliano style italiano finished and polished molar filling

Fig.12
Final result after finishing and polishing.

Conclusions

Modeling the entire occlusal anatomy at one time is becoming more and more a necessity if we are to exploit new materials. This can lead to better results in terms of time and quality. Less time to layer means we have more time for the details and for finishing and polishing the restoration.

Bibliography

1. Chiodera G. Essential Lines. styleitaliano.org 2018
2. Manauta J, Salat A. Layers, An atlas of composite resin stratification. Quintessence Publishing, 2012
3. 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.

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