A clinical case by our Community members Dr. Natalia Jakubowicz
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In daily dental practice, restorative procedures constitute a substantial portion of clinical work. Simplifying these treatments without compromising quality is therefore essential. Advances in modern dentistry have provided clinicians with innovative materials and techniques that facilitate efficient workflows and predictable, high-quality outcomes.
Universal-shade composites such as Vittra APS Unique (FGM, Brazil) exhibit a remarkable chameleon effect, seamlessly blending with the surrounding tooth structure and reducing the need for complex shade selection. When combined with the Espresso Posterior Technique, clinicians can achieve restorations that are not only fast and predictable but also highly aesthetic and functionally precise.
Fig.1
The patient presented to the dental clinic seeking comprehensive treatment. Several fillings were indicated for replacement, including those on teeth 16 and 14, due to leakage and secondary caries. The restoration on tooth 15 was evaluated as satisfactory and did not require replacement.
Fig.2
After removing the previous restorations and caries, a thick rubber dam (NickTone) was placed to achieve isolation from tooth 16 to tooth 13, which is crucial for adhesive procedures.
Fig.3
Selective enamel etching was performed for 30 seconds with 36% orthophosphoric acid.
Fig.4
A universal bonding system (Ambar Universal APS, FGM, Brazil) was applied and actively rubbed for 15 seconds, then air-dried for an additional 15 seconds to evaporate the solvent, and subsequently light-cured.
Fig.5
Two sectional matrices with a thickness of 0.04 mm were placed simultaneously. For tooth 16, a Quickmat matrix (Polydentia, Switzerland) was used, and for tooth 14, a Quickmat Prime anatomical sectional matrix was selected. Tooth 14 was prepared for the build-up of the distal proximal wall.
Fig.6
After restoring the distal proximal wall with composite resin (Vittra APS Unique, FGM), the myQuickmat Prime ring and matrices were removed. The ring was then repositioned on teeth 16 and 15 to restore the mesial proximal wall.
Fig.7
After rebuilding the mesial proximal wall and removing the ring and sectional matrix, the proximal wall height was verified. It is important to ensure that the height of the proximal walls matches the marginal ridges of the adjacent tooth (tooth 15); otherwise, the restoration may be too high in occlusion and require extensive adjustment. The Posterior Misura instrument (LM, Finland) was used to ensure the proximal wall height corresponded precisely with that of the neighboring tooth.
Fig.8
Layered reconstruction of the cavities in teeth 16 and 14 was performed using Vittra APS Unique composite resin, applied in increments not exceeding 1.5 mm. A 1.5 mm space was intentionally left for the final occlusal layer, which was modeled using the Espresso Posterior Technique.
Fig.9
When modeling with the Espresso Posterior Technique (FMT, as described by Hardan, Akhundov et al.), the composite is first placed flat in the cavity to ensure complete adaptation to all cavity margins. It is noteworthy that before polymerization, Vittra APS Unique (FGM, Brazil) appears whiter than the natural tooth; however, after light-curing, its shade blends seamlessly with the surrounding dental tissue.
Fig.10
Next, a thin instrument (LM Arte, Solo Posterior) was used to sculpt the composite and reproduce the natural occlusal anatomy of the tooth. After modeling the final layer, the composite was light-cured. The same procedure was then repeated for tooth 14.
Fig.11
The figure shows the modeling of the composite, reproducing the occlusal anatomy of tooth 14 prior to light-curing. Vittra APS Unique appears whiter than the natural tooth before polymerization.
Fig.12
The situation after creating the fissures and completing the final polymerization is shown. It can be observed that the color of the composite blends harmoniously with the natural tooth structure after polymerization.
Fig.13
After removing the rubber dam, the occlusal contact points were checked using 200 µm articulating paper (Bausch) followed by 8 µm articulating foil (Bausch).
Fig.14
Final situation after polishing. The composites on teeth 14 and 16 show excellent color matching with the natural dentition, thanks to the superior optical properties of the universal-chroma composite used in this case, Vittra APS Unique (FGM, Brazil).
Conclusions
Direct posterior restorations continue to represent one of the most common procedures in everyday dental practice. The ability to achieve precise contact points, natural anatomical form, and harmonious color integration—while maintaining efficiency and reducing chair time—defines clinical excellence in modern restorative dentistry.
By combining predictable techniques such as the Espresso Posterior Method with advanced universal composites like Vittra APS Unique (FGM, Brazil), clinicians can obtain restorations that meet the highest standards of aesthetics, function, and longevity. These innovations not only simplify daily workflows but also enhance the overall quality and predictability of restorative outcomes.
Bibliography
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