The Right Tools for A Successful Outcome

Published Date 11/29/2012

A Succesful Mesial-Occlusal-Distal Restoration

All-bond universal from bisco A 43-year-old female patient presented for a routine dental examination and periodontal maintenance procedure. An oral evaluation revealed that she was managing her periodontal condition, and that she had successfully stopped smoking for 18 months.

I performed a visual intraoral examination using 4.0x-500 loupes (Rose Micro Solutions), and an SDI diagnostic transillumination attachment on an Radii Plus curing unit (SDI).

An evaluation of the patient's dentition revealed a failing existing distal-occlusal composite restoration on tooth No. 12 that was placed in June 2008. In addition, there was a development of a mesial marginal ridge fracture of that same tooth, which I identified with the use of the SDI diagnostic attachment.

Using these tools, the diagnosis was that a Class II restoration on the mesial, occlusal, and distal surfaces was needed. I discussed this diagnosis with the patient as well as the treatment option of a direct composite restoration. The patient agreed.

Beautifil Flow Plus F00The patient chose this option for its direct and conservative approach. She also wanted to have a tooth-colored restoration. I decided to use a modified resin cone technique1 that I developed using Beautifil Flow Plus 00 and 03 (Shofu) with ALL-BOND UNIVERSAL bonding agent (BISCO) to reduce the polymerization shrinkage and internal stresses that can develop with typical composite restorations.

The final outcome resulted in a very successful mesial-occlusal-distal restoration.


Modified Resin Cone Restorative Technique

  • •Place an appropriate matrix and wedge system and use a total- or self-etching bonding agent on the restoration.
  • •Use Beautifil Flow Plus 00 (Shofu) in the proximal box and cure the material.
  • •Place more Beautifil Flow Plus 00 in either the other proximal box or at the point farthest away from the previously placed material. Cure the material.
  • •Fill the space between the 2 Beautifil Flow Plus 00 resin cones that were placed and cured with Beautifil Flow Plus 03 (Shofu). This step will connect the 2 previous segments together. Cure the material.
  • •Remove the matrix and wedge.
  • •Trim and polish the completed restoration.


Before shot of patient's failing exising distal occlusal composite restoration

Preparation of patient's tooth using a FG 330 bur from SS WhiteApplication of ALL-Bond Universal bonding agent from Bisco

Application of Beautifil Flow Plus 00 from Shofu into mesial box of preparationApplication of Beautifil Flow Plus 00 using the modified resin cone restorative technique

Cured mesial and distal aspects of the restoration Application of Beautifil Flow Plus 03 to fill isthmus of preparation

Final Restoration of tooth number 12

Modified resin cone restorative technique from Shofu Dental Trimmed, contoured and polished final restoration using OneGloss polishing points from Shofu

SS White
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