May 22, 2023
Carlos Fernandez Villares, Dr.

Aesthetic and long lasting direct composite restoration in the anterior area

Longevity and aesthetic with direct composite resins in the anterior area. Direct composite resins can be used daily to give back to the teeth and patient a natural outcome on aesthetic and function.
In the direct restorative procedure all the steps count to have the highest longevity of the treatment. From the shade and material selection, to the tooth preparation, adhesion, composite application and finishing and polishing procedures, each step have a role in the longevity.
Using techniques and materials that can simplify our restorative procedures and ensure us a higher longevity is the most predictable way for the clinical success.

Initial situation

A female patient came to the dental office in 2007 to restore the right central incisor due to a sport accident.
The tooth had already an existent composite restoration.

Initial situation

In this case we did a silicon index to guide us on the shape and did the restoration with the composite 3M™ Filtek™ Supreme XTE.

direct composite restoration in 2007

This is the immediate result with the direct composite restoration in 2007.

After 14 years (2021)

After 14 years (2021), the patient came to replace the restoration and she asked us for external teeth whitening.

external whitening

After the external whitening we waited for 15 days to avoid adhesion problems and shade stabilization and went to the new restorative procedure.

Take a bite registration silicone index

As we have the correct shape, already obtained 14 years ago, we just take a bite registration silicone index (Occlusfast Rock by Zhermack SpA) to use as a palatal silicon index.

Palatal Silicon index

Palatal Silicon index.

Shade selection

Shade selection with the different colors and opacities of the composite 3M™ Filtek™ Supreme XTE.

Isolation of the field with rubber dam

Isolation of the field with rubber dam.

Eliminate the old composite

To eliminate the old composite we use a bur that allows us to control the thickness (FG 8388P F6 STYLE FINALE by Intensiv and Styleitaliano).

Remove the old restoration

We remove the old restoration and reshape the cavity with a round bur (FG 4201 D7 STYLE DIRETTO by Intensiv and Styleitaliano).

Always finishing with carbide tungsten to avoid the debris of diamond burs and to obtain better dentin (RACU 83014 D4 STYLE DIRETTO by Intensiv and Styleitaliano).

Protect adjacent teeth with a metal matrix

Protect adjacent teeth with a metal matrix.

Sandblasting and cleaning

Sandblasting and cleaning the teeth with water system.

3M™ Scotchbond™ Universal Plus

After the applying of the etching during 15 second we proceed applying the adhesive system (3M™ Scotchbond™ Universal Plus) in a selective enamel etch mode.

3M™ Filtek™ Supreme XTE WE

Applying a palatal layer of white enamel composite (3M™ Filtek™ Supreme XTE WE).

Build up the inter-proximal area

To build up the inter-proximal area we place a sectional matrix (Polydentia SA) in a vertical position.

3M™ Filtek™ Supreme XTE

Layer of dentin with 3M™ Filtek™ Supreme XTE A1D.

Adding white tints

Adding a small quantity of white tints to emulate the adjacent tooth.

3M™ Filtek™ Supreme XTE WE

Final layer of enamel with 3M™ Filtek™ Supreme XTE WE with the spatula (Solo Anterior by LM-ArteTM and Styleitaliano).

Finishing the composite with a brush

Finishing the composite with a brush (Compo-Brush by Smile Line SA and Styleitaliano).

Oxalate gel

Covering the composite with oxalate gel and light curing for 20 seconds.

3M™ Sof-Lex™ Contouring and Polishing Discs

Primary anatomy with the aluminum oxide discs (3M™ Sof-Lex™ Contouring and Polishing Discs).

Creating the vertical grooves first with a round bur

Creating the vertical grooves first with a round bur (RA 201 GB F1 STYLE FINALE by Intensiv and Styleitaliano).

Creating the vertical grooves with a fine bur

Creating the vertical grooves with a fine bur (RA 540 F5 STYLE FINALE by Intensiv and Styleitaliano).

Final shine

Final shine with the Lucida System (DiaShine®).

Final result of the direct composite restoration

Final result of the direct composite restoration.

Carlos Fernandez Villares

Learn more about Carlos Fernandez Villares

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