Dual-layer technique in the anterior region
March 3, 2020
Prof. Paulo Monteiro, DMD, MSc

Simple & beautiful: Dual-layer technique in the anterior region

Would you like to offer your patients predictable restorative treatments in the anterior region? Let us convince you that veneers are not the only option!

Beautiful teeth of the young female patient.

When a restoration is needed in the upper anterior region of a patient with particularly high aesthetic demands, many dental practitioners prefer indirect over direct restorative techniques. Reasons are a seemingly higher predictability and easier handling of the materials inside the mouth. However, it is possible to achieve beautiful results with little effort using direct composite materials as well – provided that the character of the tooth is analysed properly and a suitable material is selected. A possible technique that supports the dental practitioner in obtaining great treatment outcomes is illustrated below.

discoloured composite restoration on the upper right central incisor

The small discoloured composite restoration on the upper right central incisor is visible and creates a disharmony in the overall picture. The proportion of the tooth is not ideal, either.

adjacent tooth shows different opacities

Analysis of the teeth’s character: The adjacent tooth shows different opacities including highly translucent areas on the incisal edge, but no intrinsic colours to be imitated.

Shade selection with two options A1 (left) and B1

Shade selection with two options A1 (left) and B1 of the VITA classical A1-D4 shade guide. According to the Styleitaliano recipes, the selected shade A1 is produced with 3M™ Filtek™ Supreme XTE Restoratives in the shades A1D (dentin) and A3E (enamel).

Creation of a smooth, bevelled surface with a polishing disc

Creation of a smooth, bevelled surface with a polishing disc (3M™ Sof-Lex™ Contouring and Polishing Disc) under rubber dam isolation.

Checking the available space and the shape

Checking the available space and the shape of the planned restoration with a silicone key.

Selective enamel etching of the prepared tooth structure.

Selective enamel etching of the prepared tooth structure.

Application of 3M™ Scotchbond™ Universal Adhesive

Application of a universal adhesive (3M™ Scotchbond™ Universal Adhesive) according to the manufacturer’s instructions for use.

Placement of the first palatal layer

Placement of the first palatal layer of composite in the Clear Translucent shade.

Vertical use of a posterior tooth matrix

Vertical use of a posterior tooth matrix to restore the mesial interproximal wall with the shade A3E (enamel).

The dentin core is created

The dentin core is created and mamelons are added to copy the natural look of the left central incisor using the shade A1D (dentin).

Placement of a layer of composite in the shade Clear Translucent

Placement of a layer of composite in the shade Clear Translucent to lay the foundation for a uniform surface with 0.5 mm space left for the final enamel layer.

Situation prior to finishing and polishing

Situation prior to finishing and polishing.

Pre-polishing with the 3M™ Sof-Lex™ Diamond Polishing System

Pre-polishing with the beige spiral of the 3M™ Sof-Lex™ Diamond Polishing System.

High-gloss polishing

High-gloss polishing with the pink spiral and water.

Restoration after the finishing and polishing procedure

Restoration after the finishing and polishing procedure.

beautiful restoration

The restoration is beautiful, while the soft tissue needs some time to recover.

Treatment result several days after the treatment

Treatment result several days after the treatment.

Beautiful smile of the young and pretty patient

Beautiful smile of the young and pretty patient.

Simple and predictable technique

The described technique is easily taught and learned. It enables every dentist to obtain beautiful results despite a highly efficient procedure. However, these results are only achieved if high-quality materials are used and if the practitioner has developed a thorough understanding of the employed materials. Instead of magic, it is precise preparation and careful planning that leads to the desired, repeatable and therefore predictable outcomes loved by the patient.

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