Building contours and contacts in anteriors is always a challenge, in this article we can learn how to achieve both in a very simple way. It is not only the matrix strategy which leads to success of simple anterior restorations, but the composite mass selection and its opacity which allows us to fully concentrate on the modeling technique and composite placement.
Some years ago I had terrible problems while layering 2 or more masses in anterior proximal cavities as the ones depicted below. These restoration represented a big challenge by being extremely difficult to calibrate and anticipate the color outcome by the mixture of two superposition masses as enamel and dentin. There were 3 possible outcomes:
1 – Restoration too translucent because of an enamel excess
2 – Restoration too opaque because of a lack of enamel and much display of the dentin
3 – Perfect outcome with perfect balance
Being the third situation the most unpredictable and the less common.
It has been already 8 years since I haven’t used 2 or more masses in this kind of restorations for many reasons, one of them is because by using a single shade with balanced opacity solves most cases with the precision shown in this final picture.
Achieving a precise contact point and a nice contour is possible by focusing all our concentration in modeling. Using a single mass helps to do so as it will be no longer necessary to think about thickness of the material. I would like to present you a simple case, that if managed wrongly could become a daily problem or vice versa.
Garrison Slick Bands SM Bands
Garrison Composi-Tight M Bands
Garrison Composi-Tight Gold Bands
We will make a single shade personalised shade guide with a Body shade and we will choose the color with the best match. Depending on the composite system is not necessary to build a shade guide, the color correspondence with VITA allow to use the Vita Classical and use the correspondent body shade.
a) separate teeth
b) protect the rubber dam
c)temporarily displace the papilla
At this stage, we place the matrices simultaneously, one per cavity, facing each other on the convex side. This strategy gives the advantage of self stabilization of the matrix even in more extreme cases. One matrix supports the other and vice versa. There are very few cases that do not allow the synchronized placement of the matrices.
We will describe how to obtain a very strong contact point with this strategy, using all time concepts.
Working with a trustworthy protocol of a single shade and focusing on the shape and modeling rather than on the color will help us very much on achieving daily success in such a challenging restorations. The systematic use of body shades as a single mass for class III and class V restorations transformed these cavities from being challenging to being again and easy and repeatable daily protocol.
1. 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 Spring;5(1):102-24.
2. Manauta J, Salat A. Layers, an Atlas of Composite Resin Stratification, Quintessence 2012.