old broken amalgam filling

Restoring multiple posterior teeth with art and creativity

A clinical case by our Community member Dr. Sarmad Hijran

 

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.

 

This case came to me with multiple issues in the posterior area. A bad composite restoration at 45, a fractured amalgam restoration at 46, and the same at 47 with a recurrent carious lesion. The patient wished to fix them all.

clean laities with liner

Fig.1

Old restorations were removed after rubber dam isolation, and carious tissue was cleaned. The dark area of discoloured dentin was covered with a new liner, so it would not show through the composite layers.

matrices for class 2 composite restorations

Fig.2

Face-to-face class 2 is always a challenge. Two matrices were placed to restore the cavities and removed, one at a time after turning the cavity in a class 1.

flowable composite to fill deep cavities

Fig.3

First proximal ridge was built and the matrix removed.

proximal ridges on molars built with composite

Fig.4

Contact area restored and boxes closed, then we were ready to restore the occlusal anatomy.

composite restorations with beautiful characterisation of sulk

Fig.5

Occlusal anatomy was restored, with beautiful natural appearance. A few extra anatomical features were added to the surface and some tint to enhance the appearance of the restorations.

occlusal check of composite restorations

Fig.6

Occlusal check, revealed a very little high spots which is more than ideal after restoring multiple molars, especially after replacing usually very flat amalgam restorations. To achieve such pre-finishing precision, thorough knowledge of the posterior anatomy is key.

polishing lucida paste on posterior teeth

Fig.7

After occlusal correction, the restorations were polished with the single-step Lucida composite gloss system.

Tip: just a few drops, no need to make a mess.

Lucida star felt for gloss by styleitaliano

Fig.9

Polishing with the Lucida star-shaped felt.

Tip: try to use low speed first, and then increase the speed for more gloss.

polished composite restorations on lower molars and premolar

Fig.10

Final result reveals a nice, glossy surface.

Conclusions

Composite restorations are the modern solution for many problems regarding posterior teeth. Correct use of composite and thorough scientific knowledge ensure great outcomes and consistent results. Of course, the artistic side of the dentist is a plus. Composite restorations are long lasting and natural-looking if we know how to make the best of the material.

Bibliography

1. Dias W. New techniques and tools for approximal restorations of class II. Walter Dias. DentArt Magazine 2012 No66
2. Devoto W, Saracinelli M, Manauta J. Composite in everyday practice: how tochoose the right material and simplify application techniques in the anterior teeth. Our J Esthet Dent 2010;5: 102-124.
3. Hirata R, Kabbach W, de Andrade OS, Bonfante EA, Giannini M, Coelho PG. Bulk Fill Composites: An Anatomic Sculpting Technique, J. Esthet. Restor. Dent. Off. Publ. Am. Acad. Esthet. Dent. Al. 27 (2015) 335–343. doi: 10.1111/jerd.12159.