Andrés Roman

14 Sep 2013 - 8967

Andrés Román
Associated professor of Operative Dentistry of the Argentina Catholic University


Application of the custom rings technique

Due to the recent publication of Jordi Manauta about this technique, I decided to apply it because of its great benefits like copying an intact proximal wall or some old restoration with an adequate shape for its subsequent replacement, this could be done in the single restoration or multiple restorations and even neighbor cavities. In this particular case i found a second premolar with its mesial and occlusal wall intact with a wide palatal embrassure, it was then when I decided to adopt this technique to restore it faithfully as possible to its original shape. I would like to thank Jordi Manauta for its collaboration in this chapter, and for many more things, a humble dedication to Pablo Santoro my mate in the CEDGROUP y and to my wife Euge.

Fig. 1

Image showing the intact occlusal surface, this image is valuable for its subsequent reproduction.

Fig. 2

Image showing the proximal lesion and the wide palatal embrassure.

Fig. 3

Customized ring technique (personalized ring), with the application of photocuring resin (also called liquid dam) copying the proximal aspect and the embrassures to be restored.

Fig. 4

Conservative removal of decay.

Fig. 5

Wedge application, and the the preformed matrices followed by the modified ring with resin, in this way the system copies the original anatomy. See the original publication.

Fig. 6

Composite stratification in two stages of the proximal wall with a medium value enamel UE2 with the instrument “LM arte Condensa by styleitaliano”.

Fig. 7

The second increment of resin is placed in the proximal box, it is contoured and its level corrected with the instrument LM Arte Fissura with the extreme sharp tip.

Fig. 8

A thin increment can be applied in order to optimize the anatomy of the ridge, and one polymerized the matrix is removed, transforming a complex cavity into a simple one, always with the same enamel.

Fig. 9

With the LM Arte condensa, the Universal Dentin (UD6) is applied in two or more stages.

Fig. 10

View of the final shape of the dentin, leaving the right space for the enamel.

Fig. 11

With the same “Condensa” the enamel UE2 is applied, using as a reference the initial picture with the original anatomy that will be sculpted with the instrument Fissura.

Fig. 12

Increment of IW (intensive white) with the aim to coy the small ridges.

Fig. 13

Ocher stain added with the Fissura thin tip copying the shape form the initial picture.

Fig. 14

Free walls are finished and polished with different grit discs.

Fig. 15

Polishing with rubber tips.

Fig. 16

Polishing with a Optibrush with no water.

Fig. 17

Followed by other consistency brushes with no water as well.

Fig. 18

Flossing and contact point assessment.

Fig. 19

Immediate postoperative image.

Fig. 20

15 days control. With the right rehydration we can appreciate the mimetism of the restoration.