A new case by our ZERODONTO Group Expert Dr. Vincenzo Vitale
Is it possible to restore an incisal edge with a single mass composite?
To date, using a single adhesive, a single bulk composite and two rubbers it’s possible to create direct restorations with high aesthetic without going through articulated layering.
The aim of this article is to show how it is possible to recreate a highly biomimetic morphology and color with a single composite mass and with a simplified adhesive process.
Direct composite restoration of 2.1
A 30-year-old patient presents for clinical observation with a class II fractured incisal edge according to Ellis.
The first step to take is to evaluate the occlusion using a 40u paper in order to be able to carry out an occlusal analysis and have a reference of the occlusion to replicate and/or confirm after the restoration.
Since the lesion is superficial, no anesthesia is performed.
The isolation of the operating field is achieved with a medium thickness rubber dam.
We proceed with the smoothing and the creation of a bevel on the enamel using a fine grain diamond flame bur mounted on a turbine.
This will allow for a better final integration by disguising the transition between composite and enamel.
The latter is finished and polished with an abrasive disk mounted on a contra-angle.
Once the preparation phase is complete, a metal matrix is applied to protect the adjacent element and the adhesion process is carried out.
It begins with etching with orthophosphoric acid at 37% for 15/20 sec.
Rinse thoroughly with water for the same amount of time.
Blow with air for 15/20 seconds and apply the universal adhesive with a microbrush and an active brushing movement of about 40 seconds.
The adhesive is blown with the air syringe to make it stretch and to evaporate the solvent.
It then light-cures for 10/15 seconds.
The chameleonic composite is then applied, recreating the same morphology of the controlateral tooth.
The modeling phase is completed by polymerizing for 20 sec.
With an abrasive disc, the modeling and the enamel-composite junction are finished.
Polishing is achieved with two polishers used at 7,500 rpm.
Once everything is finished, the rubber dam is disassembled and the occlusion is checked first with a 40u paper and then with an 8u one in order to have greater accuracy during the occlusal examination.
The simplification of protocols and the reduction of operating times make therapies faster, also allowing for an already predictable post-operative evaluation. The degree of dehydration, in fact, is minimal and very close to the 14-day check where a perfectly integrated composite restoration results.
