Occlusal composite fill |
Additionally, restoring these detected lesions can take on many forms to keep with the minimally invasive theme, including no preparation options such as ICON (DMG/America), to glass ionomers and direct composite resins. Many times, composites offer dentists the most simple and cost-effective way to create esthetic restorations, but not without a significant learning curve. It’s been more than 50 years since Buonocore thought of bonding to enamel with the introduction of acid-etching, and though the resin-based fillings of that period were quite inferior to those available today, issues related to material properties and handling characteristics, as well as the clinician’s skill, are still key to the success or failure of a composite restoration.
Today’s flowable composites allow for more widespread use in both anterior and posterior applications. Some offer larger increment or bulk-fill capabilities due to their low-shrink/low-stress chemistry (SureFil SDR Flow, DENTSPLY/Caulk; GrandioSO Flow, VOCO), while others offer self-adhering properties where a separate dentin-bonding agent is not used (Vertise Flow, Kerr Corp). Not to be outdone, the traditional body composites have been fine tuned to the point where particle size and distribution yield amazingly esthetic results balanced with equally impressive physical properties. These attributes, coupled with innovative and reproducible placement techniques, can elevate the dentist’s ability when using direct composites to create successful, long-lasting restorations.
When considering the multitude of options available for esthetic restorative cases, the use of conservative measures in our treatment planning is always a prudent measure. Creating a philosophy and solution that is conservative, functional, esthetically pleasing, and possesses good longevity should be our paramount goal. The use of direct composite resin offers an excellent tool by melding improved dental materials and technology with innovative delivery techniques to help solve these esthetic dilemmas.
Douglas L. Lambert, DDS, FACD, FASDA, FASD, ABAD, graduated from the University of Minnesota Carlson School of Management in 1980 and the University of Minnesota School of Dentistry in 1984. He is a lecturer, author, and independent dental consultant for various manufacturers, and a partner in an esthetic-based practice in Edina, Minn., emphasizing cosmetic, comprehensive, and sports dentistry. Reach Dr. Lambert at [email protected] or view his lecture schedule at www.dentalteamconcepts.com.
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