cosmetic dentistry_ beauty & science International

state-of-the-art composite resin (IPS Empress Direct, Ivoclar Vivadent). _Initial steps and tooth preparation As the degree of tooth discolouration varied from mild to medium, a preparation depth of 0.3to0.5mmwassufficient.Followingminimally invasivepreparation,aretractioncordwasplaced to prevent contamination of the working field withsulcusfluid(Fig.3).Whenfabricatinglayered restorations,theapplicationoftheadhesiveisthe step most prone to error. Therefore, it is advisable touseanadhesivesystemthatiseasy-to-use,but provides reliable adhesion. In the case presented, we decided to use ExciTE F adhesive (Ivoclar Vivadent). After having con- ditioned the enamel with phosphoric acid gel (Total Etch, Ivoclar Vivadent) for 30 seconds, the adhesive was brushed onto the tooth structure for 10 seconds (Fig. 4) and blown to a thin layer with a weak stream of air. Subsequently, the ad- hesive layer was light-cured for 10 seconds with the bluephase curing light using the low power mode. Then, the first composite layer was placed. Inordertoachieveoptimummasking,wechoseto use the opaque B2 shade from the IPS Empress range of dentine materials. _Layering Mimicking the shape and shade of natural teeth is a huge challenge and requires consider- able attention to detail. In order to achieve the same reflections as those of natural teeth, the dentine shade was applied in the form of an arch. As the composite material readily adapted to the preparation margins, only light pressure with the modelling spatula (Fig. 5) had to be applied. The composite increment was deliberately moulded with a slight taper towards the centre of thetooth.Inthisway,aninvisibletransitiontothe subsequently placed increments was ensured (Fig. 6). Then, the composite was light-cured with the bluephase curing light for 15 seconds using the soft start mode. Fig. 5_In the gingival portion, composite was applied in an arch shape to follow the gingival outline (B2 Dentin). Fig. 6_The composite was adapted to the natural tooth structure. Fig. 7_Placement of composite in the proximal portion of the tooth. An “arch” was moulded in this region too. Fig. 8_The A1 Dentin shade was chosen for the central portion of the tooth (mamelon area). The incisal edge was covered with translucent opalescent material. Fig. 9_Layering scheme showing the masking composite layers. I 27 industry report _ composite restorations I cosmeticdentistry 3_2011 Fig. 8Fig. 7 Fig. 6Fig. 5 Fig. 9