Although this is not an article in its academic form , the only common bond between this blog and an article is they both suggest answers ,
the majority of audience in big dental communities are those who aspire to publish clinical cases as superstar clinicians do , in most scenarios one case out of tens is publishable the rest ends up in the trash , those who use a DSLR and macro dental photography would agree , hopefully with time and dedication more publishable number of cases will show up , on this 2 years old case we managed to restore a chipped incisal edge by minimal invasive approach , how many times you did a cl IV restoration and no matter how you finished and polished but that white line on composite margin still there ?
bellow in the case with every step we’ll raise a question and discuss different clinical maneuvers .
Traumatic incisal edge chipping ,
I will shed light on two aspects out of more in this case that might help overcome this problem .
among few options which one gives better results ?
free hand , celluloid strips , wax up or direct mock up ?
among all mentioned above only Direct Mock-up gives you the chance to see the final result before your drill touches the teeth while wax up shows it on the cast and in different colors grey wax and yellow stone aren't enamel and dentin , most importantly the occlusion where in direct mock-up you have the ability to modify the palatal aspect where teeth occlude until there's no high spot again before your bur touches the teeth .
Do you still question how the heck this sheet can improve bond strength ?
let me tell you , not mentioning saliva , blood , gingival crevicular fluid , just see how stressful to look at your foggy mirror during routine examination and think again does this humidity can interfere your bonding strength ?
and here comes the first reason why you could end up with white margin between composite and enamel , it is early bonding failure .
if you don't have a sandblaster invest in one , it makes wonder improving bond strength through exposing prismatic enamel , agitation of acid etch improves bond strength as well . the better you bond the less you will see these white lines .
medium value enamel was used to build palatal shell .
A good condensation of composite and adaptation will make your composite bond better to the beneath substrate and again one more way to make white lines disappear .
I would mention one advantage of Macro photography , these lenses could show the very tiny leaks in our daily work , before taking this shot on my bare eyes i thought the case done , the camera said we're not done yet , so a refinished again .
yes our eyes aren't telescopes , having magnification can make huge difference , 6x loupes are good enough but still the issue with how our eyes percept light and get fatigued with time while camera lens never gets tired and decide to show altered picture .
on this photo you can clearly see how we ended with very smooth surface where composite and enamel meet in no place , they simply became one unit , the main game changer is actually proper finishing and polishing , tens of polishing protocols ,hundreds of rotary discs , brushes and even pastes out there in the market with every company almost swearing they have the best product , and i will tell you something the more you will know about god made model , the natural tooth the less you will follow blind protocols published in the web , knowing the natural model and how optically it behaves will make you create your own protocol .
posting a case on social media is not the main purpose behind proper polishing and lustering , biology is the core behind this time consuming procedure , the smoother your restoration , the less biofilm retention will stick , the less plaque retention the longer your restoration could live .
hope you enjoyed the case , it seems the much we know the more we realize we don't know , following what Steve Jobs once said "stay hungry , stay foolish " probably could take you further than you expect , i look forward for you comments , stay safe , stay blessed .
Share on:
