Amalgam replacement
June 17, 2020
Dr. Giuseppe Marchetti, DDS

Clinical Case: Amalgam Replacement Using a Bulk Fill Restorative with Increased Opacity

Direct restoration with 3M™ Filtek™ One Bulk Fill Restorative.

About the Case

The maxillary right first molar of this patient was restored with an insufficient amalgam restoration that had to be replaced, while the adjacent premolar showed a primary carious lesion needing treatment.

Initial situation

Initial situation: First molar with insufficient amalgam restoration and premolar with primary caries lesion.

Placement of rubber dam

Placement of rubber dam and separation of teeth with a wedge for easier preparation access.

Final prep after removal of amalgam

Final preparation after complete removal of the amalgam restoration and caries.

Selective enamel etch

Selective enamel etching using 3M™ Scotchbond™ Universal Etchant for 15 seconds.

Application of Scotchbond Universal Adhesive

Application of 3M™ Scotchbond™ Universal Adhesive. It is rubbed in for 20 seconds, air-dried until the solvent has evaporated and light cured for 10 seconds.

Direct application of Filtek One Bulk Fill Restorative

Direct application of 3M™ Filtek™ One Bulk Fill Restorative in the shade A2 into the cavity. As the material may be placed in layers of up to 5mm thickness, one increment is sufficient to fill the cavity.

Light Curing

Restoration directly after light curing from the occlusal, buccal and lingual surfaces for a minimum of 10 seconds each with the 3M™ Elipar™ DeepCure-S LED Curing Light.

Polishing

Polishing with the 3M™ Sof-Lex™ Diamond Polishing System. It works very well on moist surfaces and does not need paste to obtain a natural gloss.

Final occlusal check

Final occlusal check. The bulk fill restorative has a tooth-like opacity and color.

Final restoration

Final restoration at a check-up visit. Smooth and high-gloss restoration surface for a natural esthetic appearance. Different from other bulk fill materials, the discolored underlying tooth structure does not shine through.

Conclusion

This case shows that, if a dental practitioner follows some simple rules and protocols and selects high quality materials, it is easy to obtain brilliant treatment results in terms of esthetics and function. This is what StyleItaliano refers to as feasible, teachable and repeatable dentistry.

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