Microscope-Assisted Class I Composite Restoration Using GC EverX Flow and Tokuyama Estelite Sigma Quick: A Biomimetic Approach
Abstract (≈480 characters)
This case demonstrates a Class I composite restoration performed under microscope isolation using a combination of fiber-reinforced flowable (GC EverX Flow) and nano-hybrid composite (Tokuyama Estelite Sigma Quick). The workflow highlights minimally invasive cavity design, incremental layering, and biomimetic reinforcement to restore function, esthetics, and structural integrity in posterior teeth.
Author CV
Dr Hamza Zahid, BDS
Microscopic Restorative & Cosmetic Dentist
CEO – Dr Hamza Dental Center, Lahore (Pakistan)
Focus Areas – Biomimetic Restorations | Adhesive Dentistry | Microscope Dentistry | Smile Rehabilitation
Clinical Workflow
1️⃣ Initial Presentation and Isolation
A posterior molar presented with primary occlusal caries confined to enamel and dentin (Fig 1). Under rubber-dam isolation, caries was removed conservatively using a round bur and spoon excavator, preserving peripheral enamel. The cavity design was limited to the carious lesion with no additional mechanical extension.
2️⃣ Adhesive Protocol
Selective enamel etching with 37 % phosphoric acid (15 s) was followed by application of universal adhesive (GC G-Premio Bond) and light curing for 20 seconds. This ensured strong micromechanical bonding with enamel prisms and hybrid layer formation within dentin (Fig 2).
3️⃣ Dentin Replacement (Fiber-Reinforced Layer)
A 1 mm base layer of GC EverX Flow, a short-fiber-reinforced composite, was applied to mimic dentin’s stress-absorbing properties and reduce polymerization shrinkage. It was light-cured for 20 seconds under magnification (Fig 3). The fiber reinforcement enhanced internal strength and minimized flexural stress at the cavity floor.
4️⃣ Enamel Layering (Esthetic Build-Up)
The occlusal enamel was reconstructed using Tokuyama Estelite Sigma Quick in an incremental layering technique. Each 2 mm layer was shaped anatomically, following the natural cusp inclinations. Oblique layering minimized C-factor stress and improved marginal adaptation (Fig 4).
5️⃣ Finishing and Polishing
After final polymerization, occlusal anatomy was refined with fine-grit diamond burs and finishing discs. Final polishing was completed using Sof-Lex spiral wheels and PoGo micro-polishers, achieving enamel-like gloss and smooth surface texture (Fig 5).
6️⃣ Post-Operative Evaluation
The final restoration demonstrated ideal occlusal contact, marginal seal, and seamless optical integration with adjacent enamel (Fig 6). The patient reported complete comfort and improved masticatory efficiency.
Outcome
The combination of GC EverX Flow and Tokuyama Estelite Sigma Quick provided excellent biomimetic reinforcement, fracture resistance, and esthetics. The fiber-reinforced sublayer acted as a dentin substitute, while the nano-hybrid enamel layer reproduced natural translucency and gloss.
Image Captions
- Fig 1: Pre-operative view showing occlusal caries.
- Fig 2: Cavity preparation under microscope isolation.
- Fig 3: GC EverX Flow base applied for dentin replacement.
- Fig 4: Incremental layering of Tokuyama Estelite Sigma Quick.
- Fig 5: Finishing and polishing sequence.
- Fig 6: Final restoration showing natural optical blending.
Bibliographic References
- van Dijken JWV et al. Durability of Short Fiber-Reinforced Composite in High-Stress Areas. Dent Mater 2015;31(5): 545–554.
- Dietschi D. Layering Concepts in Composite Restorations for Natural Esthetics. Pract Periodontics Aesthet Dent 1997;9(2): 127–138.
- Magne P, Belser UC. Adhesive Restorations and Biomimetic Dentistry. Quintessence, 2002.
- Peumans M et al. Clinical Effectiveness of Contemporary Adhesives. J Dent Res 2020;99(4): 360–368.
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