New improved materials in direct anterior restorations

Shadeguides - Direct anteriors
4 Feb 2016

Modern dentistry is at the centre, thanks to the clinical requests, of many important changes in recent years by introducing new direct techniques and new products to simplify the daily work.

Fig. 1

16 years old female patient came to the office to change previous inappropriate class IV direct composite restorations on teeth 1.1 and 2.1

Fig. 2

The initial situation with teeth in occlusion gives us valuable information about color and opacity as well

Fig. 3

Like a dental technician if you delete color you can concentrate on shape and texture.

Fig. 4

In all my class IV complex cases I like using rigid silicon stents from a preliminary study on model casts and an accurate wax up

Fig. 5

They really help me as a guide in the planning and management of palatal walls, shape and emergency profiles

Fig. 6

Vestibular enamel preparation was limited to clean, well finished margins, using a rounded bevel, highly recommended once using new body materials

Fig. 7

I never bevel the inter-proximal and palatal margins because it would be much more difficult to stratify and finish. All modern composite materials need a solid and not so thin interface.

Fig. 8

So I use a diamond bur working only on the head

Fig. 9

Great care is taken to finish the preparation margins using silicone rubber points on a blue ring handpiece, to carefully smooth the preparation and eliminate the prisms of unsupported enamel which would break off during polymerization contraction and lead to discoloration and infiltration of the restorations

Fig. 10

I strongly recommend using this new family of bonding. Due to this technology we can use it as a self etch, as an etch and rinse but the best option is as a selective etch system on enamel.

Fig. 11

Brilliant EverGlow represents a new generation of composite material with special fillers. Due to its smart translucency balance, the shades integrate extremely harmoniously into the existing dental arch.

Fig. 12

After flasking palatal walls I like to put a little amount of flow on the cervical step to anchor the palatal walls without risking of breaking them, before removing the silicon matrix

Fig. 13
Fig. 14

Reconstruction step of the dentinal body using a single shade A1/B1 mass leaving a small free space with the incisal ridge for opalescence and internal features

Fig. 15

Effect blue through mammellons and some little white spots

Fig. 16

The final outcome showing a natural integration in shape and color

Fig. 17

With a very high lustre