CATEGORY AUSTRALASIAN DENTIST65 CLINICAL and the entire defect is restored with incremental layering cusp by cusp to avoid a high C-factor. e morphology of the tooth is taken into consideration during cusp-by-cusp layering in order to restore it close to the anatomy of a natural tooth. Step 9: Occlusal points e rubber dam was removed, and high points were checked with 40 microns paper followed by 8 micron foil. Since we want to avoid the migration of tooth no. 47 to the mesial missing tooth no. 46 space, we tried to get the points on the marginal area on adjacent teeth. In addition, points on buccal surfaces were kept for crossstabilisation (Pic 07). is way, during static and dynamic occlusion, the teeth migrate towards each other rather than going away, which will avoid space formation in the future. IOPA is taken to ensure perfect seal, contact, and contours (Pic 08) Step 10: Finishing and polishing protocols Finishing and margination of the occlusal surface was done using Dura-Green Stone, polishing with SHOFU OneGloss MidiPoints, and super polishing with SuperBu impregnated discs to achieve a high gloss for the extra enamel-like lustre. Pic 07a. e patient was recalled after 3 weeks for a checkup and informed about the use of a water osser to maintain regular oral hygiene. (Pic 09,10) Pic 02 Pic 03 Pic 07 Pic 07a Pic 04 Pic 05 Pic 06 away creating separation between the teeth and giving tight contacts in the end. (Pic 02) Step 6: Etching and Bonding A selective etching technique was used with a 35% phosphoric acid solution, followed by abundant rinsing with water. To achieve reliable adhesion, my personal preference is to use a sixthgeneration bonding system (Shofu FL-Bond II), a gold-standard bonding system. Even if you etch dentin, the primer is able to wet these surfaces without collapsing collagen and facilitate e ective penetration into the demineralized area. To maintain a humid dentinal substrate, a generous amount of primer should be applied, left undisturbed for 10 seconds, and air dried for 5 seconds to ensure the solvent evaporates. is way the mild acid primes the dentin. e bonding agent should be carefully applied as an even layer on the entire restorative surface and light-cured for 30 seconds (10 seconds is enough for shallow defects) due to deeper defects. e light cure is the most important part of composite restoration, as it will help in the degree of conversion of the monomer. Please be sure that your curing light has a curing depth of 10 mm, even from a wider perspective. Step 7: IDS and building a proximal wall / contact with stress-reducing layering techniques After applying the bonding agent, a thin layer of Shofu Injectable Xsl (high-strength self-levelling 2nd generation injectables) was used to seal the dentin. is rst layer has to be very thin (approx. 0.5 mm); this way we will protect the hybrid layer from shrinkage stress. Since this material has self-levelling properties, it moves on uneven surfaces more e ectively, leaving no air bubbles and no post-operative sensitivity. e contact was built with Shofu Beauti l LS II (low shrinkage bioactive packable composite 0.85%) in two sections, buccal and lingual, in order to avoid shrinkage. is way, we create contact and a marginal ridge as well. Re ne the marginal ridge with a ne instrument to get the proper contour and even occlusal embrasure (Pic 03) e band from tooth no. 47 is removed, Step 8: Restoring tooth no. 48 e silver restoration was removed, and all bonding steps were followed as above without removing the band on tooth no. 48. e Strata-G blue ring is selected again and secured on the tooth without moving the band or the wedge (Pic 05). e same incremental layering technique is used as above (Pic 06) Pic 8 Pic 09 Pic 10 Pic 11 Acknowledgment Author wishes to thank Garrison Dental Solutions and Shofu Dental Asia-Paci c for material support. u For the full list of references, contact Australasian Dentist on: gapmagazines@gmail.com
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