Small class IV restorations are always a challenge cause if we want to disguise them we need to make a big bevel removing enamel that, as a must, we always like to protect. New materials and opaquers allow us to make these restorations in an easy way with less effort.
Fig.1
Middle age woman comes to the office to repair an incisor that has been broken by a fork.
Fig.2
Isolation is always a must for adhesive restorations.
Fig.3
The preparation is made with the Aquacare system…
Fig.4
…that allow us to micro etch with oxide aluminum and water.
Fig.5
To bond we will use a universal adhesive but prior we etch the enamel cause in anterior restorations this tissue is the more predominant and the adhesive will perform better with this approach.
Fig.6
So we etch.
Fig.7
During 15-20 seconds.
Fig.8
And we remove very well the acid with the aspiration system and…
Fig.9
…water.
Fig.10
Now we are ready to bond.
Fig.11
We use universal bonding in several coats.
Fig.12
Polymerizing.
Fig.13
The pink opaquer layer allows us to disguise the fracture line in an easy way and help the next color to be more mimetic with the natural teeth.
Fig.14
Now is time to finish with a single shade A2 color.
Fig.15
3M Filtek Universal composite allows us to obtain a similar result as with polychromatic restorations but in an easier way.
Fig.16
After initial polymerization we cover the restoration with oxalate gel.
Fig.17
And we make the final polymerization.
Fig.18
Then we start the finishing and polishing procedures with sof lex discs…
Fig.19
…diamond bur…
Fig.20
…carbide tungsten bur…
Fig.21
…yellow spiral…
Fig.22
…and purple one…
Fig.23
Before removing rubber dam.
Fig.24
Dehydration due to the time with the rubber dam.
Fig.25
One month recall.
Fig.26
Close up one month recall.
Fig.27
Lateral view one month later.
Conclusions
Universal composite is here to solve a wide range of restorative situations. Classically we make polychromatic restorations in anterior teeth or make big preparations to disguise fracture lines but now, this new material and opaque composite allow us to face these situations in an easier way. Handling, mimetic and enough colors to cover most of the clinical situations in anteriors and posteriors makes this material really interesting for daily use in the dental office.
Bibliography
1. Manauta J. www.styleitaliano.org/single-shade-everyday
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. Baratieri LN., Araujo Jr E.M., Monteiro Jr S. “Composite Restorations in Anterior Teeth: Fundamentals and Possibilities.” Quintessence Books
4. Dietschi D. “Layering concepts in anterior composite Restorations.” J. Adhes Dent 2001; 3: 71 80
5. Manauta J., Salat A. “Layers, An atlas of composite resin stratification.” Quintessence Books, 2012
