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12 DENTAL TRIBUNE Middle East & Africa Edition | January-February 2015aesthetiCS By Prof. Luca Giachetti, MD, DMD, MSc Department of Dentistry, University of Florence, Italy I ntroduction The evolution of compos- ite materials and adhesive techniques has considerably changed the approach to resto- rations in posterior areas. The advantages of adhesive restora- tions are not only of an aesthetic nature, but, above all, relate to the possibilities of conserving a greater amount of healthy tissue and “reinforcing” the residual dental structure. However, to exploit these ad- vantages fully, we need rigorous clinical procedures which can limit what has always been the main flaw of composite materi- als: the polymerization shrink- age and the resulting stress which is responsible for most clinical failures. Manufacturers have focused their efforts on producing ma- terials which are ever easier to use and which, at the same time, are able to minimise their asso- ciated problems. The recent introduction of the SonicFill™ System follows this direction. SonicFill combines the attributes of a low viscos- ity composite and a universal composite. By activating the composite with sonic energy, it is possible to fill the cavity and adapt the low viscosity material easily, and then compact and model it while the composite changes its consistency until it reaches a higher viscosity. The manufacturer claims that it has the advantages of being: Fast: working time is reduced; it is possible to carry out single in- crements to an individual maxi- mum thickness of 5 mm. Reliable: reduced shrinkage and good adaptability to the cav- ity walls due to the low initial viscosity. Easy: it is possible to deliver the material using a small-diameter cannula and foot switch control. We present a clinical case below in which direct restorations have been produced with SonicFill on 3 elements of the 1º quadrant. Clinical Case Male patient, with an acceptable A new method for direct composite restoration of the posterior teeth 1. Initial case: 1.6 old amalgam with mesial- caries to be replaced, 1.5 primary distal decay, 1.4 old amalgam to be replaced 4. Access to the approximal carious lesions 7. Sectional metallic matrices contraposed on 1.6 and 1.5 stabilized with a wooden wedge, MetaFix All-in-One matrix stabilized with a wooden wedge on 1.4 10. Application of the Self-Etch OptiBond XTR – Bonding Adhesive System 13. Adaption of the material in the cavity with the CompoRoller oval tipped instrument and modelling with the point shaped tip 2. Isolation of the operative area with a rub- berdam stabilised with a universal SoftClamp 5. Cavity cleaning, removal of demineralized tissue 8. Matrices in situ, the adaption at the level of the cervical floor can be seen 11. Application of a thin layer of low viscosity Premise Flowable composite 14. Application of the SonicFill composite in the occlusal distal cavity to the oblique ridge 3. Clinical situation after removal of the amal- gam restorations. The contiguous elements are protected with metallic matrices before the marginal ridges are broken down 6. Finishing of the margins with SonicSys inserts 9. Application of the Self-Etch OptiBond XTR – Primer Adhesive System 12. Complete filling of the OM cavity of 1.6 with the SonicFill composite 15. Modelling the SonicFill composite with a Suter DD1-DD2 instrument > Page 13 level of oral hygiene. In the max- illary right posterior quadrant, several deteriorated amalgam restorations are present with signs of marginal infiltration compatible with the age of the restorations, and signs of wear and tear in the zones of interoc- clusal contact. Tooth 1.5 haspri- mary decay on the distal aspect of the tooth. The treatment plan was to replace the old amalgam restorations and to treat the pri- mary caries with direct compos- ites. DENTAL LABORATORY Order online at qualident-online.com or Call +971 4 342 7576 QBRIDGE CAD-CAM INNOVATION by QUALIDENT SMARTDENTAL RESTORATION Our new digital product family using CADCAM digital impressions Implant Bridge using CADCAM digital impressions Order online at qualident-online.com or Call +97143427576