cosmetic dentistry - beauty & science

18 I I research _ conservative dentistry The restorative process begins with an optional etching step; seventh-generation adhesives do not require a separate etching step. A brief etch, 15 sec- onds or less, is unlikely to harm the bonding strength ofthedentalsurfaces.Etch-Rite(Pulpdent)isapplied to the enamel first and then the dentine (Fig. 23) and rinsedoffwithcopiouswaterlessthan15secondsla- ter(Fig.24).Then,thepreparedtoothsurfacesaredis- infectedwiththeASEPTIMPlus,OzonixorHealozone. Each of these treatments takes one minute or less of chair time, and offers greatly improved restorative predictability. BeautiBond seventh-generation sin- gle-component, single-step adhesive (SHOFU) is ap- plied to all prepared dentinal and enamel surfaces (Fig. 25). It is left undisturbed for ten seconds, and is then completely dried with an oil-free air syringe (Fig.26).BeautiBondisthenpolymerisedwithaFUSION high-power LED curing light (DentLight; Fig. 27). Next, the cavity is filled utilising the innovative resin cone technique (as opposed to the more lab- orious and time-consuming layering technique). SculptableBeautifilFlowPlusF00isinjectedontothe bondedsurfaceofthepreparation(Fig.28).Thecom- posite forms into cones at the bases of the buccal cusps (Fig. 29) as it adapts intimately to the prepara- tion. Since Flow Plus F 00 is a non-flow resin, it stays where it is placed until curing. Flow Plus F 00 is then injected to form the cones at the bases of the lingual cusps (Fig. 30), from the cavity floor to the occlusal, until all four cusp bases have been restored (Fig. 31). The injected cones are then polymerised with the Fusion curing light (Fig. 32). Once the cone build-up is complete, Beautifil Flow Plus F 03 is injected to seal the marginal areas (Fig. 33) and the valleys between thecones(Fig.34).FlowPlusF03isalow-flowmate- rial that can readily be shaped by the Duckhead in- strument(Hu-Friedy;Fig.35)priortofinallightcuring (Fig. 36). The Duckhead composite instrument min- imises (and in many cases, eliminates) the need for occlusaladjustmentandpolishing,furtherimproving the efficiency of the restorative protocol. The com- pleted restoration (Fig. 37) demonstrates the clinical result of the technique and material enhancements that are available to the practitioner today. _Conclusion Innovations in end-point determination, cavity surfacedisinfection,andthesimplificationofrestora- tivetechniqueshaveagainrevolutioniseddentalprac- tice. Mainstream clinical procedures are better, faster, easierandmuchmorepredictableinthelongterm._ Editorial note: A complete list of references is available fromthepublisher. cosmeticdentistry 3_2012 DrGeorgeFreedmanispast presidentoftheAmerican AcademyofCosmeticDentistry andtheChairmanoftheDental InnovationsForum(Singapore). Heistheauthororco-author of11textbooks,morethan 400dentalarticles,and numerousCDs,videosandaudiotapes,andisa memberoftheREALITYeditorialteam.Hismost recenttextbookis“ContemporaryEstheticDentistry” (Elsevier).DrFreedmanisco-founderoftheCanadian AcademyforEstheticDentistryandadiplomate oftheAmericanBoardofCosmeticDentistry. _about the author cosmeticdentistry Fig. 35 Fig. 36 Fig. 37 Fig. 32 Fig. 33 Fig. 34