Single body shade posteriors

Cases - Direct posteriors
2014-01-20

When optical properties like hue, translucency, opacity, chromaticity, saturation, value and opalescence are restored, dental restoration may prove to be even more realistic. The optical parameters of a composite restoration primarily are affected by the composite resin composition. The effectiveness of optical scattering depends on the size of the filler. As the filler is smaller the efficiency of the optical scattering is higher. In the same time light scattering and gloss retention depends on how the filler is arranged and distributed within the resin matrix. The combination of larger and smaller fillers or filler clusters has a major influence on the shades and levels of translucency of a natural tooth-like restoration.

The most recent innovations are the nanofilled composite resins. Their mechanical and physical properties are similar to the microhybrid composite resins, above all presents an increased polishability and long term gloss retention.

Nanofilled composite resins can be found in many translucencies. The most opaque shades are dentin shades, but translucency increases when comparing body shades to dentin shades. Translucency of chromatic enamel shades is in-between the translucency of body shades and achromatic enamel shades. The wide range of opacities makes this composite resin ideal for dual-shade or multi-shade technique. The 3M ESPE expanded the range of Filtek Ultimate Body shades to provide more options for an ideal single-shade match.

Translucency, value and chroma are intimately correlated in direct composite resin restoration. These optical properties can be affected by any variation during layering. In case of a single-shade technique the esthetic outcome of the restoration is influenced by the stratification design.

The evaluation of the optical properties outcome can be carried out once the restoration is finalized and polished. In case the importance of a more esthetic outcome is higher, a translucent external layer should be applied.

Fig. 1

Detail of the matrix adaptment

Fig. 2

Custom ring repositioning. It fits perfect on the wedge. Custom ring adapts the matrix to the walls.

Fig. 3

Vestibular view.

Fig. 4

An extremely thin base liner polymerized for extended time. (40 sec).

Fig. 5

The premolar’s distal wall is constructed with 3M Filtek Ultimate A3 Body shade.

Fig. 6

detail on perspective

Fig. 7

The custom ring and the matrix removed. Now the shape can be seen precisely. Marginal ridge reconstructed. Only minimal excess was obtained.

Fig. 8

Layers imitating dentin are oblique bulk of 1 mm. Same material was used, 3M Filtek Ultimate A3 Body shade. The color is ideal.

Fig. 9

Last layer built cusp-by-cusp, approximately 0,5-0,8 mm with the same material 3M Filtek Ultimate A3 Body shade. Important to achieve a perfect anatomy in posterior region as well.

Fig. 10

Increments growing by 1mm aprox.

Fig. 11

Occlusal surface in modeling stage.

Fig. 12

The occlusal surface modeled and ready for stains.

Fig. 13

Lateral view.

Fig. 14

Morphology details.

Fig. 15

Morphology details

Fig. 16

Morphology details

Fig. 17

Morphology details

Fig. 18

The stain technique: stain goes trapped superficially in the fossae and sulcus. Long polymerization time for a good surface hardness.

Fig. 19

Stain details

Fig. 20

Stain details

Fig. 21

Morphology details

Fig. 22

Ready for finishing

Fig. 23

Finishing and polishing

Fig. 24

Finishing and polishing details

Fig. 25

Prior to isolation removal.

Fig. 26
Fig. 27

Finishing and polishing details

Fig. 28

Finishing and polishing details

Fig. 29

Immediately post operation. Restoration should look slightly darker than the remaining tooth structure.

Fig. 30