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Upper lateral incisor


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Sometimes the restoration of a simple cavity could give a lot of problems. Building contours and contacts in anterior teeth is always a challenge, mainly if you have to replace two proximal anterior restorations. The management of contact points, the shade of the teeth, and the removal of old composites can easily complicate the restorations. However, the use of Synchro Matrix and the modern bulk fill composites can help the dental clinician to make such restorations easier and more predictable. A 43 years old female came to our attention in order to improve her smile.



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Fig.1

The patient’s main complaint was the aesthetic of 1.1 and 1.2. The central and lateral incisor had, respectively, an old composite and a decay.



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Fig.2

Separating the teeth with the wedge, both the teeth were cleaned with burs.



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Fig.3

In the following step, the cavities were cleaned using 27 microns Al2O3 with regulated pressure and water spray (AquaCare).



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Fig.4

Two posterior matrixes were placed vertically in order to reconstruct the teeth. The wedge was used to stabilize the matrixes.



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Fig.5

On the lateral tooth, after an etching phase by 3M™ Scotchbond™ Etching Gel, bonding by 3M™ Scotchbond™ Universal Adhesive, 3M™ Filtek Universal Restorative was used to fill the whole cavity, maintaining the shape of the tooth, and to fill the deep layer on 1.1.





Fig.6

After filling the lateral tooth, the distal matrix was removed in order to achieve a better contact point and a better control of the restoration shape.



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Fig.7

The buccal view of the restorations before the finishing and polishing procedures.



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Fig.8

An iron strip was used to finishing interproximally. The rubber dam was not removed in order to take the gingiva down and protect it.



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Fig.9

The 3M™ Sof-Lex™ Extra-Thin Contouring and Polishing Discs were used to finish the restoration.



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Fig.10

Spiral Wheel of 3M™ Sof-Lex™ Diamond Polishing System was used to finish and polish the restoration.



Fig.11

Buccal view of the final restorations.



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Fig.12

Final restoration immediately after the rubber dam removal.



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Fig.13

One-week control.



Conclusions



With such material, we can be successful in the everyday dentistry. Although there is an objective difficulty on class III cavities, such material gives a perfect aesthetic integration of the restorations. The Bulk One technique has been used by the author and can be replicated by many colleagues, since it is fast, feasible and repeatible.



Bibliography



-J. Manauta, A. Salat, A. Putignano, W. Devoto, C.F. Villares, L.S. Hardan, Natural, polarized light and the choice of composite: a key to success in shade matching of direct anterior restorations- Part I., Odonto-Stomatol. Trop. Trop. Dent. J. 39 (2016) 11
– R. Hirata, W. Kabbach, O.S. de Andrade, E.A. Bonfante, M. Giannini, P.G. Coelho, Bulk Fill Composites: An Anatomic Sculpting Technique, J. Esthet. Restor. Dent. Off. Publ. Am. Acad. Esthet. Dent. Al. 27 (2015) 335–343. doi:10.1111/jerd. 12159.
– A. Van Ende, J. De Munck, K.L. Van Landuyt, A. Poitevin, M. Peumans, B. Van Meerbeek, Bulk-filling of high C-factor posterior cavities: effect on adhesion to cavity-bottom dentin, Dent. Mater. Off. Publ. Acad. Dent. Mater. 29 (2013) 269– 277. doi:10.1016/j.dental.2012.11.002.
– R. Monterubbianesi, G. Orsini, G. Tosi, C. Conti, V. Librando, M. Procaccini, A. Putignano, Spectroscopic and Mechanical Properties of a New Generation of Bulk Fill Composites, Front. Physiol. 7 (2016). doi:10.3389/fphys. 2016.00652.

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