• Clinical Case: Stabilising Complex Cases with Single Shade Composites

    December 05, 2021

    Before and after image

    Clinical Case: Stabilising Complex Cases with Single Shade Composites

    Using 3M™ Filtek™ Universal Restorative and 3M™ Filtek™ Supreme Flowable Restorative.

    Dr Jordi Manauta, Italy

    About the Case

    One of the benefits of using a single shade of composite in a restorative procedure is that it allows the clinician to focus on the shape of the tooth, which is critical to the final aesthetic outcome.

    The patient was unhappy with the results of previous orthodontic and restorative treatments and expressed a desire for a more aesthetic outcome. A diagnostic and aesthetic assessment were the first stages in the treatment of is complex case.

    • Pre-operative aesthetics.
      Step 1:

      Pre-operative aesthetics.

    • Teeth ready for restorative treatment.
      Step 2:

      Three months after crown lengthening bone surgery, patient is ready for restorative treatment.

    • Colour selection mock-up
      Step 3:

      Completed color selection with direct mock-up using the “button technique.”

    • “try-in” approach -  simulating the composite by the thickness, opacity, and colour on the tooth to be treated.
      Step 4:

      Another approach to shade selection is to “try-in” the composite by simulating the thickness, opacity, and colour on the tooth to be treated. It is important that the teeth stay hydrated during this procedure, as desiccated teeth appear much whiter than they otherwise would.

    • Conditioning existing restoration.
      Step 5:

      Conditioned existing restoration by sandblasting with 29-micron aluminium oxide.

    • Etched bonding surface
      Step 6:

      Etched bonding surfaces with 3M™ Scotchbond™ Universal Etchant and rinsed with water after 15 seconds. Then applied 3M™ Scotchbond™ Universal Adhesive, rubbed for 20 seconds, air-thinned for 5 and light-cured for 10.

    • Cervical contour created using the “Front Wing” technique
      Step 7:

      Used the “Front Wing” technique to create cervical contour, emergence profile, and tooth dimensions. Used 3M™ Filtek™ Universal Restorative, Shade A1.

    • Optimised distal and mesial contours.
      Step 8:

      After matrix removal, both distal and mesial contours are optimised.

    • Pre-finishing composite
      Step 9:

      Pre-finished composite before beginning construction of neighbouring teeth.

    • Correcting small defects
      Step 10:
    • Protecting neighbouring tooth.
      Step 11:

      Protected neighbouring tooth with matrix while placing 3M™ Scotchbond™ Universal Etchant.

    • Modelling the buccal area
      Step 12:

      Modelled the buccal area of the tooth using a wide instrument designed for direct veneers (SOLO Anterior, LM Instruments, Finland).

    • Backfilling the front-wing matrix
      Step 13:

      Finished backfilling the front-wing matrix.

    • Restoring left canine
      Step 14:

      Restored left canine and premolar using same technique as central incisors, focusing on shape and contours.

    • Restoration after rubber dam removal.
      Step 15:

      Restoration after rubber dam removal.

    • Finishing and polishing
      Step 16:

      Finishing and polishing completed using 3M™ Sof-Lex™ Diamond Polishing System!

    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.