Minimally invasive treatment of cervical caries

A clinical case by our Community member Dr. Hassan Hikmat

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.

Treating cervical caries in anterior teeth is a routinely challenge in our practice. To safeguard aesthetics and sound tissues, as in any other challenge, different approaches can be used, as long as feasible and repeatable.

buccal caries in a young patient’s mouth styleitaliano style italiano

Fig.1
Initial situation, a young patient who will receive an orthodontic treatment, has cervical caries and hypomineralized enamel at teeth 23 and 24.

cervical caries styleitaliano style italiano

Fig.2
Isolation was done by using a heavy sheet of rubber dam with floss knots retracting the gingiva, exposing more of the tooth structure to have a better vision and access to the lesion.

sandblasting of superficial caries styleitaliano style italiano

Fig.3
The patient refused infiltration treatment for financial reasons. Preparation was minimally invasive, as lesions were cleaned by Aluminum oxide sandblasting (AquaCare).

sandblasted teeth to remove superficial caries style italiano styleitaliano

Fig.4
After sandblasting teeth were perfectly clean, and ready for the bonding procedures.

etching under rubber dam isolation styleitaliano style italiano

Fig.5
Etching with phosphoric acid for 30 seconds.

clean surfaces before bonding procedures styleitaliano style italiano

Fig.6
Tooth surfaces after etching. As the preparation was limited within the enamel, an enamel composite shade is the only one needed.

raw composite layered on buccal surface styleitaliano style italiano

Fig.7
Enamel shade from the CompoSite system (White Dental Beauty, Optident UK) has a great shade matching due to its superior mimicking properties, and also has very good manipulation characteristics.

water soluble polishing paste and lucida star felt style italiano styleitaliano

Fig.8
Restorations were finished by enhance cups (Dentsply, USA) and polished using the simplified Lucida system, star felt and sub-micron, hybrid and water-soluble paste.

polished composite surfaces styleitaliano style italiano

Fig.9
Final situation after polishing, enamel shade from the CompoSite system (White Dental Beauty) has a natural shade matching and high polishability that helps us get natural fillings when it is polished by the right polishing system.

polished and invisible buccal direct restorations styleitaliano style italiano

Fig.10
Recall visit.

Conclusions

In this kind of cases, a minimally invasive treatment is always the right choice, while satisfying the highly esthetic needs of our patients by applying an easy procedure associated with using a good equipment and products, as the first step to achieve an excellent final result.

Bibliography

1-Manauta J, Salat A. Layers An Atlas of Composite Resin Stratification. 2012. Quintessence Pub.
2-Devoto W, Saracinelli M, Manauta J. Composite in everyday practice: how to choose the right material and simplify application techniques in the anterior teeth. Eur.
J. Esthet Dent 2010; 5: 102-124.
3-Angie Segatto. Smart Powder for cavity preparation 2 – The key to success. 2017

RELATED CASES

Can You see composite shrinkage?

Have you ever seen composite shrinkage? We do talk about it a lot, but can we, as clinicians, see what is it all about? How strong it really is? And does it exist at all? In this short article the author shares a simple experiment to show clinically existence and true strength of composite polymerisation shrinkage.