cosmetic dentistry_ beauty & science

28 I I technique _ perimeter preparation A giomer flowable (Beautifil Flow Plus) has recently been introduced (Fig. 2). It combines all the healing advantages of giomer science with the ease of use, handling and adaptability of flowable composites. The physical performance (compres- sivestrength,wearresistance,etc.)ofBeautifilFlow Plus has been tested against leading hybrid com- posites and has been found to be equal or better. In addition, Beautifil Flow Plus is radiopaque. Beautifil Flow Plus is the ideal restorative mate- rial for the perimeter preparation. It fulfils all the necessary criteria: a flowable composite resin that easily conforms to the intricate geometry of the narrow preparation without creating voids, has strength and wear resistance to withstand oral forces, is bacteriostatic and remineralising to pre- vent secondary caries, and is radiopaque. The tools andmaterialsfortheperimeterpreparationarenow readily available and so is the simple technique that can be incorporated into daily dental practice. _The perimeter preparation technique 1. The occlusal margins of a composite restoration have begun to break down. There is no radi- ographic evidence that decay has spread far beyond the surface (Fig. 3). 2. All decay and questionable tooth material are removed with the Fissurotomy Bur (Fig. 4). 3. The perimeter preparation is examined for any remaining decay (Fig. 5). 4. Micro-abrasion can be used to increase the sur- face roughness and bondability of the prepara- tion (Fig. 6). 5. Shofu BeautiBond the seventh-generation ad- hesive is applied to the cavity preparation (Fig. 7). 6. The adhesive is thoroughly air dried (Fig. 8). 7. A brief three to five seconds of LED light curing is all that is required for the adhesive (Fig. 9). 8. Beautifil Flow Plus is placed in the perimeter preparation and light cured (Fig. 10). The completed perimeter preparation technique offersarestorationthatwillservethepatienteffec- tively for many years (Fig. 11). The perimeter preparation is an effective treat- ment option for proactive intervention dentistry. The dentist has the tools, materials and techniques to manage restorative marginal breakdown at an early stage, before more extensive treatment be- comes necessary. This is simpler and more pre- dictableforthedentist,aswellasmorecomfortable and less invasive for the patient._ Editorial note: A complete list of references is available fromthepublisher. Fig. 9_The adhesive is light cured. Fig. 10_ Beautifil Flow Plus (SHOFU) is placed in the Perimeter Preparation and light cured. Fig. 11_The completed Perimeter Restoration will now serve the patient effectively for many years. cosmeticdentistry 2_2013 DrFayGoldstep(FACD,FADI, FADFE)hasbeenanADA SeminarSeriesSpeaker,and haslecturedattheADA,Yankee, AACD,AGD,andtheBigApple dentalconferences.Shehas lecturednationallyand internationallyonProactive InterventionDentistry,MinimallyInvasiveDentistry, softtissuelasers,electroniccariesdetectionand magnification.Dr.Goldstephasservedontheteaching facultiesofthePost-graduateProgramsinEsthetic DentistryatSUNYBuffalo,UniversitiesofFlorida (Gainesville),Minnesota(Minneapolis)andUMKC (KansasCity).DrGoldstepsitsontheEditorialBoards ofOralHealthMagazine(Healing/PreventiveDentistry) andDentalTribune(USEdition)aswellastheAdvisory BoardofDentalAsia.SheisaFellowoftheAmerican CollegeofDentists,AmericanSocietyforDental Aesthetics,InternationalAcademyofDental-Facial EstheticsandtheAcademyofDentistryInternational. DrGoldstephasbeenacontributingauthorto 4textbooksandhaspublishedover60articles.She hasbeenlistedasoneoftheleadersinContinuing EducationbyDentistryTodaysince2002.DrGoldstep isaconsultanttoanumberofdentalcompanies andmaintainsaprivatepracticeinToronto,Canada. Shecanbecontactedatepdot@rogers.com. _about the author cosmeticdentistry Fig. 9 Fig. 10 Fig. 11