CATEGORY 72 AUSTRALASIAN DENTIST CLINICAL with the air-water-spray to remove the acid and precipitation residues, following by gently drying with compressed air (Fig. 11). Ample amounts of the adhesive Futurabond M+ were applied and distributed on the preconditioned tooth surface using a microbrush (Fig. 12). It must be ensured that all cavity areas are sufficiently covered by the adhesive. After at least 20 seconds of carefully scrubbing the adhesive into the tooth surface, the solvent was carefully evaporated with dry, oil-free compressed air from the bonding agent until a glossy, immobile adhesive film resulted (Fig. 13). Then, the bonding agent was subsequently light-cured for 10 seconds (Fig. 14). The result was a shiny cavity surface, evenly covered with adhesive (Fig. 15). This should be carefully checked, as any areas of the cavity that appear matte are an indication that insufficient amount of adhesive has been applied to those sites. In the worst case, this could result in reduced bonding of the restoration in these areas. If such areas are found in the visual inspection, additional bonding agent is selectively applied to them to optimize the adhesive layer. Using the freehand technique and a transparent matrix, the incisal edge of the left lateral incisor was lengthened and simultaneously straightened with the universal composite GrandioSO Unlimited (VOCO, Cuxhaven) (Figs. 16 and 17). After contouring, the composite was cured for 10 seconds with a polymerization light (light intensity > 1200 mW/cm²). In the second step, the distal tooth defect was filled with GrandioSO Unlimited, and the composite was light-cured again (Fig. 18). GrandioSO Unlimited was then applied to the entire labial surface as a direct composite veneer to optically reduce the palatal position of the tooth and thus achieve an improved position in the dental arch (Fig. 19). The proximal contours were shaped using the "matrix pull" technique according to Corky Willhite24. Finally, the restorative material was polymerized again for 10 s. The direct composite veneer was carefully finished with rotary instruments and abrasive discs. A smooth and shiny surface of the restoration was then achieved using composite polishers (Diacomp Twist, EVE Ernst Vetter GmbH, Keltern) (Fig. 20). The direct veneer slightly labialized the lateral incisor and thus significantly improved the tooth position in the dental arch (Fig. 21). Finally, fluoride varnish (Bifluorid 10, VOCO GmbH, Cuxhaven) was applied to the tooth using a foam pellet. 3. Conclusion Direct tooth-colored composite restorations allow the anterior region to be restored in a single treatment appointment in a way that mainly preserves tooth substance25. With suitable indications, correct application of aesthetic analysis, a meticulous layering technique and a certain level of manual skills of the practitioner, they nowadays compete with laboratory-made all-ceramic restorations (veneers, crowns) in many demanding situations. X Email gapmagazines@gmail.com for a complete list of references. Correspondence Address: Prof Dr Juergen Manhart, DDS Manhart Dental Academy e-mail: info@manhartdental.de Facebook: prof.manhart Instagram: prof.manhart www.manhartdental.de Fig. 13: Careful evaporation of the solvent with dry, oil-free compressed air. Fig. 14: Light polymerization of the adhesive for 10 s. Fig. 15: After application of the adhesive, the preparation shows a shiny surface. Fig. 16 & 17: Using the freehand technique and a matrix, the incisal edge of the incisor was lengthened and simultaneously straightened with GrandioSO Unlimited (VOCO, Cuxhaven). Fig. 19: GrandioSO Unlimited was applied to the entire labial surface as a direct veneer to optically reduce the palatal position and thus achieve an improved position in the dental arch. Fig. 20 & 21: Final situation: Finished direct composite veneer exhibiting a high luster surface. Fig. 18: The distal tooth defect was filled with GrandioSO Unlimited.
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