Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
GIUSEPPE MARCHETTI- -
DEEP MARGIN ELEVATION, INDIRECT ANDDIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
20598 Views - Sep 2012 indirect and direct composite restorations a clinical case Giuseppe Marchetti D.D.S., Private practice:Studio Dentistico Marchetti – Parma, Italy, [email protected]
1) Pre-operative
Page 1 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
2) Rubber dam isolation
3) Rubber dam isolation (Detail Of 3.6)
Page 2 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
4) Removal of the old and incongrous restoration and of the secondary decay
5) Detail of the cavity distal cusps are reduced because of the lack of supported enamel
Page 3 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
6) An automatrix is placed for the build-up
7) Enamel is etched for 15 seconds
Page 4 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
8) Enamel & dentine are etched for other 15 seconds
9) Application of primer and bonding in two steps and hybridization of the dentin
Page 5 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
10) For ease of impression making and next isolation and cementation a deep margin elevation is donewith an etch and rinse 3 steps techinque and a flow composite
11) Immediate dentine sealing & margin elevation & prep. Of the onlay
Page 6 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
12) Detail of the impression
13) New rubber dam isolation after one week
Page 7 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
14) Rubber dam isolation (detail of 3.6 and mesial decay of 3.7)
15) 3.7 is filled before the cementation of the composite onlay of 3.6
Page 8 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
17) Filling of 3.7 with tunnel technique
18) Filling of 3.7 with tunnel technique, occlusal view
Page 9 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
19) Fitting of the composite onlay
20) After polishing the build up with air flow, enamel is etched
Page 10 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
21) Bonding application
22) The onlay is first sandblasted
Page 11 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
23) Than it is silanized
24) And than it is bonded without curing it
Page 12 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
26) It is cured for 210 seconds for each surface
27) A first finishing abrasive strip is passed under the contact areas of 3.6
Page 13 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
28) A burr for reciprocating handpiece is used for the first finishing
29) The old and incongrous filling on 3.8 is removed and a news done.
Page 14 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
30) New filling on 3.8 (detail)
31) Finally the distal decay on 3.5 is removed
Page 15 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
32) The cavity is turned from a ii to a i class
33) And a filling is done on 3.5
Page 16 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
34) 3.5 3.6 3.7 3.8 are cured under glycerine to inhibit the presence of oxygen
35) First a multiblade burr removes the small surplus
Page 17 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
37) A finishing abrasive strip is passed under the contact areas of 3.5
38) At the end a goat hair brush with cerium oxide is passed to polish all
Page 18 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
39) The full left posterior arc is restored from 3.5 to 3.8
40) Detail of 3.8
Page 19 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
41) Detail of 3.8 from a different angle
42) Details of 3.5 3.6
Page 20 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
43) Details of 3.5 3.6 from a different angle
44) The four restorations polished
Page 21 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
45) After the rubber dam removal just some little occlusal corrections are needed
46) A final occlusal view, waiting for teeth rehydration
Page 22 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
47) After the occlusal corrections both centric occlusion (blue paper) then protrusion and lateralmovements (red paper) are good.
48) Final occlusal view, two month control
Page 23 of 24
www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, ACLINICAL CASE
Visit:
http://www.styleitaliano.org/deep-margin-elevation-indirect-and-direct-composite-restorations-a-clinical-case
Page 24 of 24
http://www.styleitaliano.org/deep-margin-elevation-indirect-and-direct-composite-restorations-a-clinical-casehttp://www.styleitaliano.org/deep-margin-elevation-indirect-and-direct-composite-restorations-a-clinical-case