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cosmetic dentistry_ beauty & science

18 I I special topic _ composite restorations Fig. 35_Fixed orthodontic brackets can be accurately located and precisely cemented with SonicFill resin. Fig. 36_Lingual orthodontic wire retained by correctly contoured (non-bulbous) resin, without impingement of the gingival margins for improved oral hygiene and periodontal health. cosmeticdentistry 1_2013 a hermetic seal to alleviate symptoms, and prevent fu- turecomplextreatment(seecasestudyinFigs.15–23). Coronalorcorebuild-up A gross loss of dentine and enamel is usually due to caries, tooth wear or trauma. In each of these circumstances, the objectives are building up the lost coronal substrate for restoring structural integrity, a foundationforasubsequentdefinitiverestorationand preventing ingress of bacteria and oral fluids. The SonicFill resin, possessing high flexural strength, com- pressive strength, hardness, and reduced volumetric contractionstogetherwithaprofounddepthofcureis proficientforachievingtheseobjectives. Forvitalteeththathaveextensivefailingorfractured restorations, a coronal reconstruction serves as a long- termrestoration,possiblyforreviewingendodonticstatus and monitoring tooth vitality before the provision of a finalrestoration(Figs.24–29).Inaddition,acutetraumas causingcuspalfractureswithpulpalexposure,necessitat- ingrootcanaltherapy,acorebuild-upactstoretainarub- ber dam clamps for isolation during endodontic therapy (Figs.30&31).Finally,forroottreatedteeth,intra-radicu- larpostscanbeusedforbuildingupacorewithSonicFill resinforsupportinganeventualcrown(Figs.32–34). Retainingorthodonticbracketsandfixedretainers Fixed orthodontic therapy involves cementing or- thodontic brackets with a resin cement or flowable composite. Because the latter possesses low viscosity, this presents a challenge for accurate location of the brackets.Furthermore,theinherentlowviscosityofce- mentsandflowablesreducesthixotropicpropertiesand makesremovalofexcessunsetmaterialatediouschore. Althoughthisisnotofficiallyincludedintheindications recommended by the company, the SonicFill resin re- solved these problems since its dispensing tip delivers asmallamountofmaterialexactlywhereneeded. Inaddition,theinitiallowviscosityoftheresinallows preciseadaptationtotheenamelsurface,andwhenits viscosity increases, the brackets can be accurately po- sitioned and excess material removed with ease before light curing. This substan- tially reduces clinical time,andavoidsinad- vertentdamagetothe surrounding enamel byscrapingwithhand orrotaryinstruments, or laceration of the gingival tissues dur- ing removal of excess setcementorflowablecomposite(Fig.35). Similarly, fixed orthodontic retainer wires can be ac- curatelypositionedonthelingualorpalatalsurfaces,and the highly viscous SonicFill unset excess resin removed prior to light curing. This avoids the frequently encoun- teredlingualorpalatalbulbosityassociatedwithsurplus composite around retainer wires (Fig. 36). Finally, since theSonicFillresinispreciselyadaptedtotheretainerwire, inadvertentimpingementofthegingivalmarginismiti- gated,thusimprovingaccessfororalhygieneprocedures, andpreventinginflammationofthegingivalmargins. _Conclusion Bulk-fill, deep resins, provide an expedient and cost effective solution for posterior direct restorations where aesthetics are not a paramount concern. The SonicFill system offers the best of both worlds; adapt- ability of a flowable and the sculptability of a universal composite with the added benefit of 5 mm depth of cure in a single increment. Deep resins: white fillings, deliveredwithsimplicityandefficiency. Inaddition,the favourable mechanical properties of the SonicFill resin and its fluctuating viscosity allow other clinical appli- cations such as core build-ups and retaining ortho- dontic fixed brackets and appliances. Finally, it is not inconceivable that future varieties of bulk-fill deep re- sinsmayincorporateself-etchingbondingagentsthat wouldobviatetheneedforapriorbondingprotocol,and therebyfurthersimplifyingandreducingclinicalsteps._ Editorial note: A complete list of references is available from thepublisher. Dr Irfan Ahmad The Ridgeway Dental Surgery 173The Ridgeway,North Harrow Middlesex,HA2 7DF,UK iahmadbds@aol.com www.irfanahmadtrds.co.uk cosmeticdentistry_contact Fig. 35 Fig. 36