CATEGORY AUSTRALASIAN DENTIST71 CLINICAL very short time, ensures that the optimally matching composite material is used for the subsequent restoration. This means that time-consuming rework or even new restorations due to aesthetic complaints from disappointed patients can be avoided in almost all cases. The superficial enamel of the labial surface of the tooth was lightly instrumented with a fine-grit finishing diamond and a small equigingival chamfer was prepared to create a perfect transition between the direct composite veneer to be made and the cervical tooth contour. In addition, the old insufficient distolabial composite filling was removed (Fig. 4). To expose the cervical preparation margin, the adjacent gingiva was displaced with a retraction cord, resulting in bleeding from the sulcus (Fig. 5). A retraction paste with astringent effect (Retraction Paste, VOCO GmbH, Cuxhaven) was applied from a capsule into the labial sulcus using a very thin, tapered cannula (Fig. 6). After a 2-minute exposure time, the paste was carefully removed completely with air-water-spray using high-vacuum suction (Fig. 7). The area was subsequently dried with compressed air. The local bleeding in the gingival region was easily and effectively stopped by using the retraction paste containing aluminum chloride and kaolin (Fig. 8). Only a clean and dry working area allows for contamination-free work in the further course of treatment. In the next step, both adjacent teeth were protected using Teflon tape (Fig. 9). The universal adhesive Futurabond M+ (VOCO) was chosen for the adhesive pretreatment of the dental hard tissue. This modern one-bottle adhesive can be used with (etch-and-rinse approach: selective enamel-etch or total-etch of enamel and dentin) or without (self-etch) prior application of phosphoric acid. In this clinical case, the total-etch adhesive pretreatment using phosphoric acid was used. 35% phosphoric acid (Vococid, VOCO GmbH, Cuxhaven) was applied on enamel and dentin (Fig. 10). Subsequently the tooth was washed thoroughly for 20 s Fig. 1 & 2: Initial situation: The left lateral incisor is clearly palatal in relation to its neighboring teeth. This disturbs the patient, who would like a better visual integration into the dental arch. Fig. 3: Shade selection on the moist tooth. Fig. 4: Removal of the old distal composite filling and minor preparation of the labial surface for a direct composite veneer. Fig. 7: After a 2-minute exposure time, the paste was carefully removed with the air-water-spray using high-vacuum suction. Fig. 10: Conditioning enamel and dentin with 35% phosphoric acid gel. Fig. 5: Displacement of the marginal gingiva with a retraction cord to expose the cervical preparation margin, resulting in bleeding from the sulcus. Fig. 8: The bleeding was easily and effectively stopped by using the retraction paste. Fig. 11: After thoroughly washing the acid and dissolved precipitates, the tooth is air-dried. Fig. 6: A retraction paste (Retraction Paste, VOCO GmbH, Cuxhaven) with astringent effect was applied into the labial sulcus. Fig. 9: Both adjacent teeth were protected using Teflon tape. Fig. 12: Application of the bonding agent Futurabond M+ with a microbrush.
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