In addition to
maintaining a
comprehensive
general and
cosmetic practice
in Laguna Niguel,
CA, Dr. Snyder is an
author, educator,
researcher, and
consultant for
several dental
manufacturers.
A graduate of
the UCLA School
of Dentistry and
the Foundation
for Advanced
Continuing
Education, he is a
faculty member at
Esthetic Professionals
and the Catapult
Elite Group. Dr.
Snyder is an
Accredited Member
of the American
Academy of
Cosmetic Dentistry
and co-author of
A Cup of Coffee
with 10 of the Top
Cosmetic Dentists in
the United States.
A 48-year-old female patient presented complaining of painful sensitivity on the lower right side of her mouth. Tooth No. 29 had an existing Class II composite restoration that had been placed by another dentist several years ago. I could tell by a simple visual inspection that the margins were failing. I decided to replace the restoration in case secondary caries had developed; the patient agreed.
I removed the composite, some microleakage and decay. My go-to rotary instruments for cavity preparation are disposable NeoDiamonds (Microcopy) because I get a fresh, efficiently cutting bur every time.
To achieve an optimal contact and anatomy for this case, I used a Composi-Tight 3D XR sectional matrix (Garrison Dental). Then I placed TheraCal LC (BISCO) over the deep area where I had removed decay to create a barrier and protect the pulp. I’ve found it to be very effective at eliminating postoperative sensitivity and at promoting healing.
For added protection, I chose to use a sandwich technique, placing EQUIA Forte (GC America), a conventional glass ionomer that will release fluoride and can help hypermineralize the damaged tooth. The remaining enamel was acid-etched with Select HV Etch (BISCO). ALL-BOND UNIVERSAL adhesive (BISCO) was then applied, followed by light polymerization using a VALO (Ultradent) LED curing light. I then placed Admira Fusion (VOCO) as the final layer. After curing, the composite surface needed only minimal finishing to produce a high luster.
The patient was thrilled that the sensitivity was gone and her tooth looked great.
