rubber dam sublingual isolation with clean cavities

Full quadrant restoration

A clinical cases by our Community member Dr. Roma Turetsky.

 

This patient came complaining about food entrapment in between teeth in the upper right quadrant.

quadrant with multiple decayed teeth

Fig.1

Upon examination we found infiltration of old composite restorations on teeth 14, 16, and 17, and a lesion on tooth 15. We decided to restore the quadrant in one single session.

caries on upper teeth

Fig.2

After the infiltration anesthesia, the preparation of teeth, removal of old fillings, opening of the proximal walls.

isolated upper quadrant with clean cavities

Fig.3

Isolation with the rubber dam (Nictone heavy). Cavities were cleaned and proximal spaces opened where needed.

matrices and wedges for adhesive procedure isolation

Fig.4

Matrices were placed before adhesive procedures. A total etching technique was used in association with OptiBond FL adhesive.

bulk filling deep cavities

Fig.5

First, tooth 17 and the proximal walls of tooth 16 and 14 were restored. The cavity floor was covered using Filtek Bulk fill flowable composite and Estelite Asteria Estelite Asteria A3B.

composite restoration of upper molars

Fig.6

The anatomy of teeth 17, 16, and 14 were finished using enamel Estelite Asteria OcE.

beautiful composite restorations

Fig.7

Fissures were stained using ochre and brown. At this stage it was very convenient to finish mesial 16 and distal 14 with Soflex discs, having full access for perfect polishing.

floss ligature and anatomical matrix for mod premolar cavity

Fig.8

A floss ligature was used to retract the rubber dam around tooth 15, as the distal margin was very gingival.

restoring mod cavity on premolar with composite and matrices

Fig.9

Anatomical matrices were placed at the same time on mesial and distal 15, and a Garrison ring was used to stabilise the matrix. Adhesive procedures were carried out, and then the tooth was restored.

finished quadrant composite restorations

Fig.10

Prophyflex was used to remove the oxygen inhibited layer before final polishing.

quadrant composite fillings after polishing

Fig.11

Photo of the restoration after polishing. Polishing pastes with different polishing capacity were used with a goat brush to get the final gloss.

occlusal check after quadrant restoration

Fig.12

Occlusal check.

xray after composite fillings

Fig.13

Immediate X-ray check.

composite fillings after rehydration

Fig.14

Photo of teeth after 3 weeks rehydration.

Conclusions

Quadrant multiple restorations are very convenient to restore in one single session.
When performing multiple restorations we have access to areas we couldn’t reach when proceeding tooth by tooth. Modern materials allow us to achieve aesthetic integration of the restoration with the tooth tissues, making the restoration seamless.

Bibliography

1. Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub.

2. Magazine «Dent-Art» Restoration of the contact surfaces in the side teeth Serhiy Radlinsky. 2015 No79 p.22-40

3.Magazine «Dent-Art» Adaptation of the matrix in cases of proximal defects with an absence of behind standing tooth. Roman Turetskiy 2018 No90. p.27-31

4. Magazine «Dent-Art» New techniques and tools for approximal restorations of class II. Walter Dias. 2012 No66