This occlusal preoperative view shows a Class I amalgam in tooth number 14 that is in need of replacement due to enamel fracture and recurrent decay.
An occlusal view after preparation is completed and the operative area is isolated in preparation for the restorative procedure.
A glass ionomer material (Fuji IX: GC America) is mixed and syringed into the cavity preparation.
The glass ionomer material is condensed into the preparation as a base prior to the addition of composite restorative material.
This view shows the completed Class II cavity preparation after glass ionomer base insertion and refinement. The Composi-Tight Gold Sectional Matrix System was chosen to aid in the anatomic restoration of the mesial proximal tooth morphology of this maxillary fi rst molar.
This slide shows a close up view of sectional matrix bands and “G-Rings” from the Compositight Gold system. The appropriate matrix band was chosen to best correspond anatomically to the tooth being restored, and also to the width and height of the proximal surface. The height of the sectional matrix should be no higher than the adjacent marginal ridge when properly placed.
A sectional matrix band is shown being held in the DryerPlier. This instrument was specifically designed to facilitate precision placement of sectional matrix bands without deformation.
The mesial DryerPlier is used to place the Composi-Tight sectional matrix band on the mesial surface of tooth number 14.
This facial oblique view shows how the DryerPlier facilitates access to posterior interproximal areas while maintaining a positive grip on the matrix band.
This slide shows the WedgeWand during clinical application. The wedge portion is bent at a 90-degree angle to the handle. This one-piece application eliminates the clumsy positioning and handling of wedges using cotton pliers or other types of instrumentation.
“G-Ring” forceps are used to correctly position the “G-Ring” in place to stabilize the matrix band against the proximal surface of the prepared tooth. The feet of the G-Ring are placed behind the flexible wedge, and the ring is released from the forceps. The force of the G-Ring causes a slight separation of the teeth due to periodontal ligament compression. It also bends the fl exible wedge to adapt and conform better to the external tooth surface, creating an excellent seal at the gingival margin of the preparation.
37% phosphoric acid etchant is placed on the enamel margins for 10 seconds.
After a 10 second etch of enamel surfaces, the dentin is etched for 5 seconds giving a total etching time of 15 seconds for the prepared tooth structure.
Rinse the etchant away thoroughly with water for at least 15 to 20 seconds.
AcQuaSeal desensitizer (AcQuaMed Technologies, Batavia, IL) is applied after airdrying to disinfect and rewet the preparation surface. Initial penetration of the low molecular weight monomer HEMA will help to seal dentinal tubules and potentiate the formation of the hybrid layer.
Application of dentin and enamel adhesive (Optibond Solo Plus: Kerr Corporation) to the cavity preparation.
The solvent (ethanol) is evaporated with a stream of air across the cavity preparation.
The dentin and enamel adhesive is light cured using an LED curing light (Demetron LED: Kerr Corporation) for 20 seconds.
Flowable resin (Revolution 2: Kerr Corporation) is applied as the first restorative increment.
The flowable layer is light cured for 20 seconds.
The MO cavity preparation is shown after the proximal increment and pulpal floor have been condensed using microhybrid composite (Premise: Kerr Corporation) and a non-serrated plugger.
Ochre composite stain (Kolor Plus: Kerr Corporation) is applied to the pulpal floor prior to placement of the enamel increments of composite.
The buccal increment is placed using a composite placement instrument and refi ned with a #2 Keystone brush. Notice the anatomic placement of cuspal inclines and marginal ridge.
The palatal increment is smoothed toward the margin with the #2 Keystone brush. Note the anatomic placement of the marginal ridge into facial and palatal increments.
An occlusal view of the completed MO direct composite after condensation and light curing.
The DryerPlier is used to remove the matrix band after removal of the “G-Ring” and flexible wedge.
An occlusal view of the completed restoration after rubber dam removal prior to placement of the surface sealant.
Application of surface sealant using a #2 Keystone brush.
An occlusal view of the direct MO composite restoration.