Case Presentation: Natural-Looking Restorations Using a Supra-Nano Filled Composite
Natural-Looking Restorations Using a Supra-Nano Filled Composite
Figure 1—Occlusal caries
I isolated the tooth with a rubber dam and removed the caries using a carbide round bur (Darby Dental) as well as a slow-speed handpiece (Midwest Shorty Two Speed, Dentsply Sirona) and high-speed handpiece (StarDental 430 Series, Dental EZ).
After cleaning and drying the tooth, I placed a resin-modified calcium silicate-filled liner (TheraCal LC, BISCO) and light-cured the material. The tooth was selectively etched with 35% phosphoric acid solution and then air-dried.
A self-cured adhesive (Universal Bond, Tokuyama) was then placed, and after allowing for further drying, a universal, supra-nano filled composite (Estelite Sigma Quick, Tokuyama) shade A3 was placed on the occusal surface. After a complete cure of 20 seconds for each area, a flowable composite (Filtek Supreme Ultra, 3M) was placed on the facial surface (shade A4) and on the occlusal surface (shade A3) between the margin of the prepped tooth and the paste area to make sure that all occlusal margins were sealed.
I used a contouring and polishing disc (Sof-Lex, 3M) to produce a smooth facial surface, and also used finishing diamond and carbide burs (Brasseler) on the facial surface. On the occlusal surface, I used an acorn-shaped burnisher (Hu-Friedy) for anatomy before light-curing and made adjustments with pointed FG shaped diamond burs (Kerr Rotary and Brasseler). After all the adjustments were complete and the occlusal was done, I used an FG shape white stone (White Arkansas Stones, Dedeco) to smooth all the composite.
Photography was taken throughout with a digital intraoral camera (CS 1200, Carestream).
The patient was pleased with the outcome.
Figure 2—Rubber dam isolation
Figure 3—Large caries into the dentin
Figure 4—Soft caries removal with carbide round bur (Darby Dental) using slow-speed handpiece (Midwest Shorty Two Speed)
Figure 5—Clean and neat cavity preparation
Figure 6—Placement of TheraCal LC liner (BISCO)
Figure 7—Placement of Estelite Sigma Quick (Tokuyama) with a condenser (Darby Dental)
Figure 8—Occlusal anatomy with an acorn-shaped burnisher (Hu-Friedy)
Figure 9—More defined occlusal anatomy with a pointed composite instrument (Blue Titanium, Pioneer Solutions)
Figure 10—Final composite restoration after adjustments with burs (Kerr Rotary and Brasseler) and polishing with FG shape White Arkansas Stone (Dedeco)
Tags: CS 1200, Carestream Dental, Sof-Lex Contouring and Polishing Discs Kit, Midwest Shorty, Estelite Sigma Quick, DentalEZ, Filtek Supreme Ultra Flowable Restorative, Tokuyama Dental America, 3M, Tokuyama Universal Bond, TheraCal LC, Dentsply Sirona Midwest, StarDental 430 Series, Filtek Supreme Ultra Flowable Restorative - Capsule Refills, 20/Pkg - Shade A1, Intraoral Cameras, Universal Composite, Low-Speed Handpieces (air-driven), Bonding Agents & Adhesives Miscellaneous, Flowable, Bases and Liners, Bisco, Inc, High-Speed Handpieces (air-driven), Finishing & Polishing Materials & Strips