Direct Posterior Bonded Restorations - An Outline of a Clinical Technique
Sergio Rubinstein, DDS;Alan J. Nidetz, DDS, Manal Ibrahim, DDS
Modern dentistry has experienced a major shift on patients’ demands from health and function to cosmetics. Materials and techniques are constantly evolving to adapt to these ever-changing needs. One major purpose of modern dentistry is not only to deliver this type of care with excellence but the preservation of healthy tooth structure is just as essential. This article describes current concepts to help consistently obtain an excellent, predictable and long lasting restoration with the direct posterior bonded restoration. Research has show that the direct posterior composite fits all of these criteria while also strengthening a tooth that has lost its integrity.
When either decay or removal of a previous restoration weakens a tooth, the direct posterior composite is the most conservative technique that can restore the original contours and colour.
While any restorative technique requires meticulous steps to achieve success, the intermediate steps during bonding are sensitive and critical. Furthermore, we recognise that if we do not control the shrinkage of the composite during its polymerisation it can create stress, microleakage, marginal breakdown, fractures and secondary caries. All of these could lead to the failure of the restoration and might necessitate endodontic therapy.
It is the Class I direct occlusal composite restoration that carries the highest stress due to the lack of free surface areas within the cavity. Therefore, the ratio between the bonded and free restoration surfaces (C-factor) is high, creating shrinkage stresses that are higher than the bond strength.
Prosthetic Gingival Reconstruction in Fixed Partial Restorations - Part 3: Laboratory Procedures and Maintenance
This third and final installment in the series focuses on the laboratory and clinical procedures involved in fabricating a prosthesis with artificial gingiva and provides information on proper maintenance of these restorations.
Prosthetic Gingival Reconstruction in a Fixed Partial Restoration - Part 1: Introduction to Artificial Gingiva as an Alternative Therapy
Prosthetic gingival restoration of a Class III defect environment.
Prosthetic Gingival Reconstruction in the Fixed Partial Restoration - Part 2: Diagnosis and Treatment Planning
This second article on the use of artificial gingiva in fixed partial restorations focuses on diagnosis and treatment planning.
Anterior Composite Restorations - The Reality of Making it Real - Part 1 of 3
Learn finishing and polishing techniques to create realism in your direct composites and these undetectable additions to enhance one’s patients smile.
The Future of Ceramics, Composites and Adhesive Dentistry
Features details on exciting new research regarding luting agents.
The Use of The Operative Microscope in Restorative Dentistry Pt 1
Using a microscope to assist in anterior composite placement.
Smile Design and The Bonded Functional Esthetic Prototype (BFEP)
The lecture will cover some simple Photoshop techniques to enhance a smile digitally to present to the patient and motivate them to accept treatment.
This lecture will mainly focus on the the step-by-step process of how to turn the 2-dimensional Photoshop smile design into a 3D Bonded Functional Esthetic Prototypes (BFEP’s) the patient wears to verify esthetic and functional acceptance. A very efficient technique using a new highly flowable but highly filled micro-hybrid that uses an injection molding tray technique will be demonstrated. A full arch composite bonding can be done in one hour with this technique. This BFEP technique can be used for “trial smiles” for pre-treatment esthetic and functional evaluation by the patient and the treatment team. It can also be used for long-term functional temporization for years if necessary. The BFEP will then be used as the final guide for preparations for Anterior Etched Ceramic restorations (porcelain veneers and glass ceramics.
Excellence in Cosmetic Dentistry: Replicating Nature, When Nature Has Been Compromised
Drs. Cherilyn Sheets and Jacinthe Paquett discuss the understanding of the art and science of dentistry to create restorations that duplicate nature.
Clinical Tips for Posterior Composites
Despite the popularity of posterior composites, it is a topic that still creates questions and frustrations for many clinicians. Our goal is to place these restorations with ease and success to create long lasting results. We will discuss preparation design, material selection, matrices, and placement techniques. One of the most common questions I get is about predictably creating tight contacts, and we will look at several techniques to ensure this happens.
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