Fig.1
Pre-operative image of tooth 25 showing an old amalgam restoration.

Fig.2
Rubber dam isolation. We began by placing the wedge using a pre-wedging technique, as described in the Styleitaliano article “Mind the Wedge”.

Fig.3
Cavity access was performed with the customized wedges in place. The preparation is extended appropriately to allow thorough cleaning and provide adequate space for proper matrix placement.

Fig.4
Using LM-Arte Cusp Misura (LM Dental, Finland), we verified adequate support of both buccal and palatal cusps.

Fig.5
In this case, both cusps were sufficiently supported by healthy tissue.

Fig.6
Selective enamel etching was performed for 30 seconds while protecting adjacent teeth with the matrix in place. The cavity is then thoroughly rinsed and gently air-dried.

Fig.7
The adhesive (Scotchbond Universal Plus, Solventum, USA) was actively applied and left to sit for at least 20 seconds.

Fig.8
The adhesive was carefully scrubbed with a brush and then gently air-thinned without light curing.

Fig.9
Placement of the Ring Polydentia My tines GO. The GO ring is the ideal partner for the matrices Quickmat Flex Fit, a slight modification on the occlusal flap was done in order to ba able to use the Posterior misura instrument (check image 13). Only at this stage the adhesive was light-cured.

Fig.10
Flowable composite was then placed to perform the snowplow technique.

Fig.11
The matrices with a small amount of flowable composite placed only in the cervical area

Fig.12
Then the interproximal wall was built using bulk-fill paste composite (Filtek One, Solventum), to provide greater density and stability.

Fig.13
LM-Arte Misura Posterior (LM Dental, Finland) was used to copy from the adjacent tooth the correct height and inclination of the marginal ridge, reducing the risk of discrepancies that could require occlusal adjustments and potentially compromise anatomy if not properly calibrated from the outset.

Fig.14
The height was then verified from the occlusal view before light curing.

Fig.15
Detail of the proximal walls after measurement. Interproximal excess was removed, and only at this stage is the proximal wall light-cured.

Fig.16
Using the Bella utility instrument allows clean and controlled matrix removal.

Fig.17
Class I restoration: flowable composite was placed on the cavity floor.

Fig.18
Light-curing. At this stage, both the flowable layer and the proximal wall can be polymerized again

Fig.19
Placement of bulk-fill composite Filtek One (Solventum) in a single increment.

Fig.20
Composite immediately after placement.

Fig.21
First phase of Essential Lines: anatomy was reproduced starting from the cavity walls and residual cusps.

Fig.22
Definition of the essential occlusal anatomy.

Fig.23
Interproximal finishing using pop-on Filtek Sof-Lex Disc (Solventum).

Fig.24
Final restoration — lateral view.

Fig.25
Final restoration — occlusal view.

Conclusions

Maintaining adequately supported cusps was a key factor in the success of this posterior composite restoration. Thanks to LM-Arte Cusp Misura, we were able to accurately determine which cusps could be safely preserved, ensuring a conservative, yet predictable restorative approach.
Material selection also played a fundamental role. A universal adhesive such as Scotchbond Universal, combined with a bulk-fill composite like Filtek One, helped streamline the restorative workflow while maintaining clinical reliability and efficiency.
In addition, the GO ring system, with its innovative central embracing design, allowed us to achieve anatomical interproximal profiles that were easy to finish and refine. All of these factors translate into valuable chairside time savings for both clinicians and patients, while supporting predictable functional and aesthetic restorative outcomes.

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