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.
Trying to rebuild a wall with its cusp is a big challenge, and it starts with a big question each and every time: is it possible to use a band here? Or is free-hand is enough? Ad in many cases, there is no one answer, and in this case I’m going to show the use of bands for building the proximal walls, and a free-hand build-up for the buccal wall.
Fig.1
Initial view showing the caries at teeth number 16 and 15.
Fig.2
Rubber dam isolation of the teeth to get better vision and clean area for work.
Fig.3
After removing the carious lesion and preparing the cavities, sandblasting with 50 micron Aluminum Oxide powder was carried out. A clean cavity with good design, showing no unsupported enamel and ready for applying the bonding system. This step is important to increase the longevity of the restoration.
Fig.4
Matrices applied together with a ring to adapt them to the walls. Proximal walls are built one at a time, and one matrix is removed after building the wall to ensure a tight contact point.
Fig.5
Build up of the buccal wall and the distobuccal cusp using Si P composite (White Dental Beauty).
Fig.6
After building up the buccal wall, the final touches are added to create the final anatomy of the teeth. As the natural teeth had little white spots on the tip of the cusps, the Si 0 shade (White Dental Beauty) was used to enhance the natural appearance of the restorations.
Fig.7
Finishing and polishing of the teeth using Lucida System from (Diashine) for the final step of polishing to create the best final luster.
Fig.8
Final view with the occlusion check using 40 micron articulation paper.
Conclusions
It is always a big challenge for the dentist to build up the buccal and lingual walls with their cusps. This article shows combination of two approaches based on the possibility of using matrices or free-hand modeling at their best effectiveness. Moreover, using a lighter shade in the occlusal third of the buccal surface greatly enhances the natural look of a restoration.
Bibliography
1. Ritter AV, Boushell LW, Walter R, Sturdevant CM. Sturdevant’s Art and Science of Operative Dentistry. Elsevier, 2019.
2. Marchetti G. 10 TIPS on Posterior direct restoration in daily flow. 2018. Styleitaliano.org
3. Siri VK. Textbook of operative dentistry 4th ED. CBS Publishing, 2017.
