cosmetic dentistry_ beauty & science

I 41 industry report _ direct composite resin restorations I cosmeticdentistry 4_2011 dicator of the presence of caries. The frequency of margin discolouration is affected by the adhe- sive chosen, the adhesive technique utilised, the composite itself and the finishing technique em- ployed. The left central incisor was first isolated from the bonding procedure using Teflon tape. The right central incisor was then treated with a dual-cure, nano-reinforced, self-etching adhesive (Futura- bond DC, VOCO; Fig. 4) and light-cured. Next, an opaque-dentine shade button was selected that best matched the tooth. The Opaque (O1; Amaris shade tab, VOCO) was matched to both the pre- pared tooth and the adjacent unprepared lateral incisor (Fig. 5). The O1 composite was then tried against the prepared tooth (Fig. 6) and sculpted, leaving a 0.5 mm thickness for the final enamel layer (Figs. 7 & 8). This composite was designed so thatitwouldnotsticktotheinstruments,allowing it to be shaped in the cavity with simple move- ments with almost no pressure. Next, the Translucent Light (TL) was matched to both the prepared tooth and the adjacent lateral incisor (Fig. 9). Then, the TL composite was tried against the prepared tooth (Fig. 10), and this final enamel layer was sculpted to shape (Figs. 11 & 12). Thesesamestepswerethentakenforthemaxillary left central incisor (Figs. 13–15). Once both maxil- larycentralincisorshadbeenrestored(Fig.16)and the occlusion checked, the restorations were fin- ishedtoproperanatomicmorphology(Fig.17)and polished (Fig. 18). _Conclusion A technique for placing direct composites that allows a predictable outcome in the aesthetic zone has been demonstrated. In my opinion, the simplicity of shade matching and aesthetics, ease of application, finishing and polishing, and the strength and durability make Amaris an ideal choice as a direct restorative material._ Fig. 15_A final layer of TL composite was placed. Fig. 16_The maxillary central incisors restored with unfinished composite. Fig. 17_The restorations after contouring and shaping, before finishing and polishing. Fig. 18_The completed case. Dr Ian Shuman runs a general,reconstructive and aesthetic dental practice in Pasadena,Maryland (USA). As an educator and author, he is a pioneer in developing advanced,minimally invasive techniques.His mission is to teach dental professionals current methods for creating beautiful,long-lasting restorations that preserve the maximum amount of tooth structure. He is a Fellow of the Pierre FauchardAcademy and a member of theAmerican DentalAssociation and theAmericanAcademy of Implant Dentistry. He can be contacted at ian@ianshuman.com. cosmeticdentistry _about the author Fig. 18Fig. 17 Fig. 16Fig. 15