Resin Composite Restorations

Question 1

Procedure for posterior composite restoration

Answer 1

• Clinical or radiographic evidence of caries and extent of disease
• Assess pulp response to Sensibility testing
• Check occlusion with articulating paper
• Select shade of composite
• Isolate tooth with Rubber dam
• Diamond fissure bur to access cavity and remove central unsupported demineralised enamel leaving a sound enamel margin
• Peripheral dentine caries removal via excavator or rose head bur in slow speed handpiece
• Lightly bevel enamel margins and smooth internal line angles
• Wash and dry cavity
• 37% phosphoric acid etch gel 10secs enamel and 10secs dentine
• Wash and dry with 3in1
• DBA applied and light cured 470nm 20secs
• Matrix band placed and wedgets used if needed to achieve contact point
• Place comp in 2mm increments in stacked angles from base outwards light curing each increment
• Ensure uncured monomer of oxygen-inhibition layer on surface of each increment undisturbed to allow adhesion to next increment
• Shape into occlusal morphology
• Light cure 20secs
• Finish margins with diamond finishing burs and check occlusion with articulation paper and polish with diamond grit impregnated discs

Question 2

Procedure of Anterior incisal edge / labial composite veneer

Answer 2

• Check palatal/ protrusive guiding occlusion with articulating paper
• Tooth shade selected
• Rubber dam
• Remove old restoration with diamond bur
• Excavate soft caries infected and stained caries with excavtor or rose head bur slow speed
• Remove extrinsic staining with sodium bicarbonate
• Ensure sound enamel margins and periphery clear
• Margins smoothed and bevel
• 37% phosphoric acid etch and DBA primer light cured
• 15mm long clear matric strip interproximal and wedge cervically
• Place increments 2mm and shape with flat plastic and light cure
• Trim margins with comp finishing bur
• Occlusion checked articulation paper and remove any heavy contact
• Polished