Stamp Technique Part 1

3 Mar 2016 - 53323

In restorative dentistry many direct composite techniques concentrate on layering protocols by adding composite increments toward each side of the cavity modeling the occlusal surface (1). It is, however, sometimes difficult to “free-hand” reproduce adequately all occlusal topography such as cusps, slopes, grooves, ridges, etc…

In few very specific cases where the occlusal surface is almost intact at the beginning of the restorative procedure a stamp technique can be an interesting alternative to “conventional” direct techniques because it allow us to quickly and easily reproduce exactly the same occlusal surface the patient had at the beginning. The technical feasibility of the so-called Stamp Technique has been proven not only in cavities but for vertical bite reconstruction of worn dentitions (2,3).

Fig. 1

Before restoring the tooth was cleaned with prophylaxis paste.

Fig. 2

Flowable Composite or even light cured Dental Dam is first applied to the dental surface to take kind of a “mini-impression” prior to prepping the cavity. Both materials accurately reproduce occlusal anatomy. The index is connected to an instrument for easy handling.

Fig. 3

Once the cavity has been properly prepared and cleaned is ready to follow the bonding procedures.

Fig. 4

A thin layer of bulk fill composite material is applied and light cured. Depending on cavity depth one or two layers should be applied keeping the last layer uncured.

Fig. 5

Then a piece of teflon tape is used to cover the occlusal surface to avoid composite sticking to the previously prepared occlusal stamp. The uncured layer of composite is pushed through the teflon piece by pressing the occlusal stamp against the tooth and light cured for 80 seconds.

Fig. 6

This is the result after teflon removal and light curing through glycerin gel.

Fig. 7

Immediate result after occlusal adjustments, polishing and glossing.

Fig. 8

Final result after 3 months post-op.

Fig. 9

Another case solved by using the same Stamp Technique.

Fig. 10

Occlusal index made with liquid dam.

Fig. 11

Cavity preparation.

Fig. 12

After teflon removal and before final light-curing.

Fig. 13

Clinicians must pay very careful attention to properly remove all excess and distortions using tungsten burs and silicone points.

Fig. 14

Final glossing.

Fig. 15

Immediate result after occlusal adjustment of both restorations.

Fig. 16

And last case to illustrate the optimum results we can achieve with this technique.

Fig. 17

Immediate result.

 

Conclusions

Combining both Stamp Technique and Bulk Fill composite materials allows us to work faster and to achieve more accurate occlusal anatomy whenever it is available from the beginning of the procedure. But… What happens if occlusal anatomy is not intact at the beginning? Can we use this technique? Next paper we will discuss a modified technique to use when previous anatomy is not intact.

Bibliography

1. Scolavino S., Paolone G., Orsini G., Devoto W., Putignano A. The simultaneous modeling technique. Int J Esthet Dent 2016;11:2-25
2. Perrin P, Zimmerli B, Jacky D, Lussi A, Helbling C, Ramseyer S. Die Stempeltechnik für direkte Kompositversorgungen. Schweiz Monatsschr Zahnmed 2013;123:111-129.
3. Simon T. Ramseyer, Christoph Helbling, Adrian Lussi. Vertical Bite Reconstructions of Erosively Worn Dentitions and the “Stamp Technique” – A Case Series with a Mean Observation Time of 40 Months. The journal of adhesive dentistry. 06/2015; 17(3).