Shape and Layer

style italiano styleitaliano dentistry

Fig.1
Preoperative: the patient, female 45 years old, asks for an esthetic improvement, not expensive not invasive.
A direct approach is proposed and accepted.
Color was taken with the aid of Smile Lite and Smile Capture in order to notice the delicate nuances.

style italiano styleitaliano dentistry

Fig.2
Isolation of the operative field with rubber dam.

style italiano styleitaliano dentistry

Fig.3
With a diamond bur, fine grain, (Direct Style, Bur 4, Komet by Style Italiano) the unsupported enamel has been removed and the previous filling too, in order to clean the secondary decay.

style italiano styleitaliano dentistry

Fig.4
With a Soflex disc the little bevel done previously is smoothened.

style italiano styleitaliano dentistry

Fig.5
A palatal view of the prep.

style italiano styleitaliano dentistry

Fig.6
A silicon guide done from the wax up is tried.

style italiano styleitaliano dentistry

Fig.7
Two posterior matrices (Hawe Blue Adapt Sectional Matrix) are customized in order to fit the silicon index, which has been cut partially in order to hold the matrices.

style italiano styleitaliano dentistry

Fig.8
Etch and rinse technique: orthophosphoric acid on the enamel for 30 seconds and to dentin for 15, then rinse for at least 30 seconds.

style italiano styleitaliano dentistry

Fig.9
Primer and bonding are applied in two steps.

style italiano styleitaliano dentistry

Fig.10
With the fissura instrument (LM kit powered by Style Italiano) the limits of the prep are marked in order to be precise during enamel mass placement.

style italiano styleitaliano dentistry

Fig.11
Enamel mass is placed on the silicone near the mark and matrices are inserted into the cuts on the silicone.

style italiano styleitaliano dentistry

Fig.12
In one movement everything (silicone, matrices and composite) are placed back in the field, the composite material is then adapted to the tooth.

style italiano styleitaliano dentistry

Fig.13
After polymerization the silicon guide is removed, with the aid of the matrices still in place, proximal walls are constructed.

style italiano styleitaliano dentistry

Fig.14
Matrices are removed only after proximal walls are built and polymerized.

style italiano styleitaliano dentistry

Fig.15
A very small amount of flow is used over the bonding to have a better conversion of the adhesive and cover possible little gaps.

style italiano styleitaliano dentistry

Fig.16
A first A3 dentine mass is placed over the prep and palatal wall, mamelons can be sculpted at his stage.

style italiano styleitaliano dentistry

Fig.17
A second small layer of dentin covers the prep line.

style italiano styleitaliano dentistry

Fig.18
A translucent enamel is placed between the mamelons and the incisal edge, then little white spots are placed to mimic the neighbor tooth.

style italiano styleitaliano dentistry

Fig.19
The final layer is done with 0.5 mm of medium value enamel.

style italiano styleitaliano dentistry

Fig.20
Final polymerization with an oxyguard to inhibit the presence of oxygen, as known it hinders the conversion of the last layer of the material.

style italiano styleitaliano dentistry

Fig.21
With a pencil the texture of the secondary anatomy is drawn.

style italiano styleitaliano dentistry

Fig.22
So with the bur 4 of the finishing kit (Finishing Style, Komet by StyleItaliano) the three lobes of 11 are reproduced at low speed.

style italiano styleitaliano dentistry

Fig.23
With the same bur texture is reproduced.

style italiano styleitaliano dentistry

Fig.24
And the restoration is polished. Following a progressive polishing procedure.

style italiano styleitaliano dentistry

Fig.25
Immediately after the dam has been removed. We have to wait for the rehydration.

style italiano styleitaliano dentistry

Fig.26
The III class of 12 was intervened as well.

style italiano styleitaliano dentistry

Fig.27
After one week: a good integration of shapes and colors, we can see the details of the white spots reproduced, and the translucency of the disto-buccal enamel that’s has been copied quite well.

style italiano styleitaliano dentistry

Fig.28
A happy patient and her nice smile.

style italiano styleitaliano dentistry

Fig.29
Details, in a lateral view.

style italiano styleitaliano dentistry

Fig.30
Before and after. Shape is sometimes as important as color.

Bibliography

1. Manauta J, Salat A. Layers, An atlas of composite resin stratification. Chapter 7 and 10, Quintessence Books, 2012.
2. Manauta, J., Paolone, G. Devoto, W. 2013. IN ‘n’ OUT – A New Concept in Composite Stratification. Labline Magazine, 3 (2), pp. 110-127

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