A Composite Classic by Dr. Anthony T. Dioguardi
This patient presented to my office after having fallen and fractured #’s 8 and 9. She had bleached her upper teeth during the past year but not her lowers. After placing a 2-3mm scalloped bevel along the margins with a flame diamond, I pumiced and etched the tooth, and followed with a one-step bonding agent. I then layered and cured a base shade B1 Renamel Microhybrid up to, but not over the bevel. I chose Renamel Microhybrid because of its excellent opaquing properties.
Next, I placed a layer of Renamel SB1 Microfill over the microhybrid, and half of the bevel. Before I cured the material I used a thin composite instrument to scallop away the incisal 1-2mm of microfill. To mimic the white fluorosis-like spots present on the other teeth, I used the same composite instrument to spot place Creative Color White Opaquer over the microfill, and cured. My final step was to place a thin layer of Renamel Incisal Light Microfill over the entire restoration, extending 1mm beyond the bevel. I find it most effective to use my gloved (nitrile, now powder) finger to press the final layer of incisal composite over the restoration. Polishing was completed with FlexiDiscs, blue and pink, FlexiCups and Cosmedent polishing paste, Enamelize.
No prep, pumice, etch, bond, Renamel shade B1 microhybrid, shade B1 microfill, incisal light microfill. Again, the Renamel Microhybrid is phenomenal at blocking the darkness from the back of the mouth.
Student on her way to China with fractured #s 8 and 9. Composite restorations enabled this girl to fix her smile in one office visit! I used the same technique as the first case, except different shades. She requested that we duplicate her pre-accident appearance as much as possible.
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