The Espresso Posterior Technique streamlines the workflow of direct posterior restorations by combining bulk placement with efficient sculpting and finishing protocols. When paired with Kerr SimpliShade™, a single-shade universal composite, this approach allows for time-efficient yet highly esthetic results, reducing chair time without compromising mechanical performance or marginal adaptation. The following clinical case illustrates, step by step, the direct restoration of two mandibular molars in a single session using the bulk-and-go protocol. The second molar presented with a primary carious lesion, while the first molar exhibited a failing composite restoration.
Both teeth were restored using Kerr SimpliShade™ universal composite and the Espresso Posterior Technique in combination with the Replica Posterior LM-Dental Instrument, demonstrating the efficiency and predictability of this approach in managing posterior restorations with different clinical indications through a unified restorative strategy.
Fig.1
Initial situation: A 23-year-old patient presented with two compromised mandibular molars. The first molar showed an old and unaesthetic composite restoration with marginal defects, while the second molar exhibited a primary carious lesion. Considering the patient’s young age and the restorative history of the adjacent tooth, early intervention was planned to prevent rapid lesion progression. In agreement with the patient, both teeth were treated in a single session.
Fig.2
A Class I cavity was prepared on the second molar and a Class II cavity on the first molar. The image shows the cavities prior to final cleaning and decontamination, with residual carious tissue still partially visible before removal.
Fig.3
Final cavity preparations after complete caries removal and decontamination. Both molars are now ready for adhesive procedures: a Class I cavity on the second molar and a Class II cavity on the first molar.
Fig.4
Selective enamel etching of the cavity margins using phosphoric acid gel.
Fig.5
The chalky-white aspect of the etched enamel confirms effective demineralization, indicating that the surface is ready for the application of the adhesive.
Fig.6
Application of OptiBond™ Universal (Kerr), a single-component universal adhesive. The adhesive was actively applied using a microbrush in a scrubbing motion for 20 seconds, followed by gentle air thinning and light curing for 40 seconds.
Fig.7
Reconstruction of the distal wall to convert the Class II cavity into a Class I configuration using the Snowplow technique. Kerr SimpliShade™ Bulk Flow was first applied and left uncured, followed by the placement of SimpliShade™ Bulk, a high-viscosity composite, to optimize marginal adaptation and eliminate voids. To accurately replicate the height of the marginal ridge, the LM-Arte™ Misura Posterior instrument (LM-Dental) was used.
Fig.8
Application of Kerr SimpliShade™ Bulk Flow for Immediate Dentin Sealing (IDS). This initial layer of flowable composite was used to even out the cavity floor and seal the exposed dentin prior to placement of the final layer.
Fig.9
Kerr SimpliShade™ Bulk, a high-viscosity composite, was applied in a single increment, filling the entire cavity according to the bulk-and-go approach. The LM-Arte™ Replica Posterior instrument was used simultaneously to adapt the material, remove excess, and sculpt the occlusal surface in just a few efficient steps.
Fig.10
After completing the restoration of the second molar with the LM-Arte™ Replica Posterior instrument, the occlusal grooves of both restorations were characterized to enhance the three-dimensional effect and achieve a more natural anatomical appearance.
Fig.11
Once the rubber dam was removed, occlusal contacts were carefully checked and adjusted to ensure functional stability and proper integration.
Fig.12
Final result after finishing and polishing procedures using the Kerr OptiDisc™, Opti1Step™ and OccluBrush™ polishing systems. These tools allowed for precise surface refinement and a smooth, glossy finish that enhances esthetics and plaque resistance.
Conclusions
The combination of a single-shade universal composite (Kerr SimpliShade™) with the Espresso Posterior technique enabled a rapid and predictable workflow, ensuring excellent adaptation, occlusal harmony, and esthetic integration. Strict adherence to adhesive protocols and careful occlusal adjustment contributed to a durable and functionally stable result, demonstrating how a bulk-and-go strategy can simplify posterior restorations without compromising quality.
While it may not represent the most refined or ideal restorative solution in absolute terms, this technique offers a reliable clinical outcome with minimal material use and reduced chair time, making it an efficient and pragmatic choice for daily practice.
Bibliography
- Tosco V, Vitiello F, Furlani M, Gatto ML, Monterubbianesi R, Giuliani A, Orsini G, Putignano A. Microleakage analysis of different bulk-filling techniques for Class II restorations: µ‑CT, SEM and EDS evaluations. Materials (Basel). 2020;14(1):31. doi:10.3390/ma14010031.
- Putignano A, Tosco V, Monterubbianesi R, Orsini G, Vitiello F et al. Comparison of three different bulk-filling techniques for restoring Class II cavities: µCT, SEM‑EDS combined analyses for margins and internal fit assessments. J Mech Behav Biomed Mater. 2021;124:104812. doi:10.1016/j.jmbbm.2021.104812.
- Manauta J, Salat A, Devoto W, Putignano A. Layers 2: Direct Composites – The Styleitaliano Clinical Secrets. Berlin‑Chicago‑Tokyo‑Milan: Quintessence Publishing; 2022. ISBN 978-88-7492-090-7.
- Chiodera G. Lines: una guida per eseguire restauri posteriori diretti semplici e di successo. Quintessenza Edizioni; 2022.
