Styleitaliano is a FREE website, help us to give you the best contents by telling us who you are and what you like.
If you are already registered, just write your mail and continue
Email not registered. Please fill the gaps to continue.

Thank you!
This e-mail address is already registered, click continue to see the content

Email:
First Name:
Last Name:
Country:
Primary profesional interest:







Continue
Continue
x

11490 Views - Dec 2015

Download PDF
Do you believe in Aesthetics in one shot? A single shade in direct posterior restorations solves this problem, especially if the selected opacity is correct, this choice becomes extremely easy as the right opacity is found in the most commonly available composites.

Composite Body shades are medium opacity masses, at the very beginning of the history of aesthetic materials, these were almost the only choice, dentin or enamel shades did not exist, or they were extremely difficult to find. Little by little complementary masses started appearing.

When composite stratification became a common method, body shades became the "lazy" alternative and many colleagues were commonly criticized for "not being refined" for using these shades. It was in fact that thousand of colleagues learned by experience that in many cases layering composites was just counterproductive. The perfect example are the posterior teeth.

Body shades are different among them, even if two shades share the exact same opacity, they may be different while transmitting and blocking light, with different light scattering features, making one more effective while masking. Optical features are vast and we will discuss them in following articles.

The author and many of the fellow members of this group agree with the following statement. "Many of the best posterior restorations I have seen in my life, to my surprise were single shades".

Preoperative view of the third quadrant, proximal caries in the distal of 36, medial of 37 and penetrating sulci in the occlusal of the 38.
Isolation details. 26 N clamp
Details of the isolation from an occlusal view, note how the rubber dam must be clean and invaginated
Before removing the decay we protect the rubber dam, retract the papilla and separate teeth with a wooden wedge under the contact area. This step is done routinely whenever treating proximal lesions.
Details of the inter proximal caries of 3.6 and 3.7
To help in removing completely the decayed tissues, a caries detector can be used with a brush
After its application we have to rinse it and the decayed tissues remain colored
This can be helpful in removing all the decay
Details of the occlusal prep of 3.8
Details of the preps of 3.6 3.7 3.8 after the cleaning and the disinfection of the dentin
Application of sectional matrices and a wooden wedge
Details of the sealing of the cervical margin
A Universal Adhesive System is chosen ( Scotchbond Universal 3M ESPE ). It was used with a selective etching technique of the enamel
Details of the etchant ( Scotchbond etching gel )
Application of the Universal Adhesive on 3.6 and 3.7
Details of the application, the bonding must be scrubbed for 20 seconds and let it act for at least an extra 20 seconds.
Details of the conversion of the adhesive after the light curing procedures. Cavity must look varnished after polymerisation, if it is not the case, we must review our procedure
Details of the shiny appearance after the light curing procedures
Details of the conversion of the adhesive from yellow to transparent after the curing procedures for 40 seconds
The centripetal build up technique: we build up the inter proximal walls and this to have a class one cavity instead of a class two. Before the removal of the matrix we fix the composite wall with a small amount of flowable composite
Details of the build up done with Filtek Supreme Flow A3
Details of the restorations done with Filtek Supreme Body A3.
Details of the restorations done with Filtek Supreme Body A3
Details of the restorations done with Filtek Supreme Body A3
Before the application of the stains and before the finishing and polishing procedures
Details after the application of the brown stains
Details after the application of the brown stains
Details after the application of the brown stains
Details before finishing and polishing procedures
Finishing procedures of the interproximal wall with a Soflex disc
Finishing procedures of the interproximal wall with a Soflex disc, this is of outmost importance in order to obtain a clear, visible and solid margin with an optimal shiny surface
First step of the polishing with a brown Spiral
Second step of the polishing procedures with a white Spiral
Details of 3.6 3.7 3.8 after the finishing and polishing procedures
Details of 3.8
Details of 3.7
Details of 3.6
Details of the contact area and of the little overcontour
Details of the restoration on 3.8
Occlusal check
One Month control
One Month control
One month control from an occlusal view, the distal overcontour of 3.6 has been removed
Before and after

Conclusions

Conclusions

A modern conservative approach for direct posterior restorations help us in creating the correct shapes both for preps and for morphology which can be reached just with the commodity of one body mass. The use of stains is not mandatory but can help in increasing the depth of those restorations.

In posterior teeth, shape is of outmost importance, shade is not a trouble anymore when choosing the right opacity.

Choose very well your composite, all composites brands are different and even though many of them share the same "name" they have very different characteristics. In other words some body shades are closer to a dentin while others to the enamel.
 

Bibliography

References

1- Spreafico R. Direct and semi-direct posterior composite restorations. Pract Periodontics Aesthet Dent 1996;8:703–712.
2- Sieber C. Voyage–Visions in Color and Form. Chicago: Quintessence, 1994.
3- Kataoka S. Nature’s Morphology: An Atlas of Tooth Shape and Form. Chicago: Quintessence, 2002.
4- Winter R. Visualizing the natural dentition. J Esthet Dent 1993;5:102–117.
5- Manauta J. Salat A. Layers, An atlas of composite resin stratification. Quintessence 2012.

ASK THE AUTHOR PRIVATELY





Privacy Policy