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.
Fig.1
Initial situation of an old infiltrated restoration.
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.
Fig.3
After rubber dam isolation, we started by removing the old restoration and the carious tissue.
Fig.4
After the old materials and carious tissue were removed, the cavity was refined and sandblasted with 27-micron aluminum oxide particles.
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.
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.
Fig.7
A flowable layer is excellent to make the bottom of the cavity more regular.
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.
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).
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.
Fig.11
Occlusion check. Minimal adjustments were needed, the anatomy was not influenced.
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.
