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

    November 02, 2021

    A smiling face showing beautiful anterior restorations.

    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!

    Prof. Paulo Monteiro, DMD, MSc

    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
      Step 1:

      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.

    • Teeth shows different opacities
      Step 2:

      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
      Step 3:

      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 (dentine) and A3E (enamel).

    • Contouring
      Step 4:

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

    • Checking the shape of the planned restoration with a silicone key.
      Step 5:

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

    • Selective enamel etching.
      Step 6:

      Selective enamel etching of the prepared tooth structure.

    • Applying universal adhesive on etched tooth
      Step 7:

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

    • Placing the first palatal layer of composite.
      Step 8:

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

    • Vertical use of a posterior tooth matrix
      Step 9:

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

    • After creating dentine core adding mamelons
      Step 10:

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

    • Composite placement
      Step 11:

      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.

    • Before finishing and polishing.
      Step 12:

      Situation prior to finishing and polishing.

    • Contouring
      Step 13:
    • Pre-polishing
      Step 14:

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

    • High-gloss polishing
      Step 15:

      High-gloss polishing with the pink spiral and water.

    • Restoration
      Step 16:

      Restoration after the finishing and polishing procedure.

    • Tooth after restoration
      Step 17:

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

    • Treatment result
      Step 18:

      Treatment result several days after the treatment.

    • A face with a beautiful smile.
      Step 19:

      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.