DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE...

GIUSEPPE MARCHETTI- -

DEEP MARGIN ELEVATION, INDIRECT ANDDIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE

20598 Views - Sep 2012 indirect and direct composite restorations a clinical case Giuseppe Marchetti D.D.S., Private practice:Studio Dentistico Marchetti – Parma, Italy, [email protected]

1) Pre-operative

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2) Rubber dam isolation

3) Rubber dam isolation (Detail Of 3.6)

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4) Removal of the old and incongrous restoration and of the secondary decay

5) Detail of the cavity distal cusps are reduced because of the lack of supported enamel

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6) An automatrix is placed for the build-up

7) Enamel is etched for 15 seconds

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8) Enamel & dentine are etched for other 15 seconds

9) Application of primer and bonding in two steps and hybridization of the dentin

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10) For ease of impression making and next isolation and cementation a deep margin elevation is donewith an etch and rinse 3 steps techinque and a flow composite

11) Immediate dentine sealing & margin elevation & prep. Of the onlay

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12) Detail of the impression

13) New rubber dam isolation after one week

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14) Rubber dam isolation (detail of 3.6 and mesial decay of 3.7)

15) 3.7 is filled before the cementation of the composite onlay of 3.6

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17) Filling of 3.7 with tunnel technique

18) Filling of 3.7 with tunnel technique, occlusal view

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19) Fitting of the composite onlay

20) After polishing the build up with air flow, enamel is etched

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21) Bonding application

22) The onlay is first sandblasted

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23) Than it is silanized

24) And than it is bonded without curing it

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26) It is cured for 210 seconds for each surface

27) A first finishing abrasive strip is passed under the contact areas of 3.6

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28) A burr for reciprocating handpiece is used for the first finishing

29) The old and incongrous filling on 3.8 is removed and a news done.

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30) New filling on 3.8 (detail)

31) Finally the distal decay on 3.5 is removed

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32) The cavity is turned from a ii to a i class

33) And a filling is done on 3.5

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34) 3.5 3.6 3.7 3.8 are cured under glycerine to inhibit the presence of oxygen

35) First a multiblade burr removes the small surplus

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37) A finishing abrasive strip is passed under the contact areas of 3.5

38) At the end a goat hair brush with cerium oxide is passed to polish all

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39) The full left posterior arc is restored from 3.5 to 3.8

40) Detail of 3.8

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41) Detail of 3.8 from a different angle

42) Details of 3.5 3.6

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43) Details of 3.5 3.6 from a different angle

44) The four restorations polished

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45) After the rubber dam removal just some little occlusal corrections are needed

46) A final occlusal view, waiting for teeth rehydration

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47) After the occlusal corrections both centric occlusion (blue paper) then protrusion and lateralmovements (red paper) are good.

48) Final occlusal view, two month control

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