Time to change old restorations
Composite restorations are done on patients with good oral hygiene. These restorations require routine followups. In these conditions they can last many years. We, as dentists, can repair them if necessary. After years, they may change color, have some chipping, wear, lack of marginal adaptation or have marginal discolorations.
Img. 1 – Young male patient came to our clinic complaining about the appearance of his frontal teeth.
Img. 2 – When we evaluated the case thoroughly, we found out that the old restorations were worn, changed in color and marginal discoloration had occured.
Img. 3 – Evaluation of the color of composite masses with different opacities, using a 5500 K light source.
Img. 4 – Evaluation of composite masses with different opacities using the same light source mounted with a cross-polarized filter.
Img. 5 – Prior to preparing the silicone index, we added some composite on worn incisal surfaces to obtain the desired morphology.
Img. 6 – Trimming the silicone that has overlapped on the vestibular surface.
Img. 7 – Isolation of the field with black rubber dam.
Img. 8 – Removing the old restorations with coarse diamond burs.
Img. 9 – Beveling the enamel surface with red banded burs. Note that in order not to open the dentine surface we can leave a thin layer of the old composite.
Img. 10 – Cleaning the interproximal surfaces using a single sided diamond metal band.
Img. 11 – Etching the beveled surfaces by protecting the neighboring teeth with teflon tape.
Img. 12 – Evaluation of the etched surfaces.
Img. 13 – Applying adhesive and light curing.
Img. 14 – Preparing palatal enamel layers with the help of the silicone index.
Img. 15 – Cleaning the excess composite from the approximal surfaces using a single sided metal diamond strip.
Img. 16 – Creating mesial walls by using a transparent band.
Img. 17 – Adding a small amount of oppalescent composite on the incisal edge.
Img. 18 – Placing dentin composite mass.
Img. 19 – Creating recess for effects with fissura.
Img. 20 – White effects placement by using the thin tip of fissura.
Img. 21 – Placing the thin enamel composite layer on vestibular surafce by using rubber tip spatulas.
Img. 22 – Smoothing surfaces with brushes.
Img. 23 – Cleaning and smoothing interproximal surfaces by using single sided abrasive strips.
Img. 24 – Marking line angles.
Img. 25 – Arranging line angles and vestibular surfaces with single sided abrasive discs.
Img. 26 – Applying glycerin gel prior to final light curing.
Img. 27 – Creating secondary anatomy by using carbide burs.
Img. 28 – Polishing by using two step diamond impregnated rubber wheels.
Img. 29 – Final appearance of the new restorations.
If the composite restoration changes its natural color, has some wear, loses its shiny surface, has bad marginal adaptation, marginal discoloration, leakage, secondary decay, chipping, cracks, fractures, we have to change them.