Please activate JavaScript!
Please install Adobe Flash Player, click here for download

Dental Tribune Middle East & Africa Edition No. 3 2015

4 Dental Tribune Middle East & Africa Edition | May-June 2015restorative Bulk fill restorations in the posterior area ByDr.AbubakarSheikh,Pakistan I ntroduction Traditionally cavities in pos- terior teeth were generally filled with amalgam. With the advent of direct composites this approach gradually changed, but there were quite a few chal- lenges that had to be overcome. These challenges included re- ducing polymerization shrink- age and postoperative sensitiv- ity, achieving tight contacts in posterior teeth and sufficient strength in load bearing areas. With the improvement in adhe- sive bonding systems and com- posite materials most of these challenges were addressed but still it has always been recom- Dr.AbubakarSheikh Associate Professor Operative Dentistry & Head of Dept. of End- odontics & Supervisor for Fellow- ship Program for postgraduate students in Fatima Jinnah Dental College. Practice owner and Specialist in RestorativeDentistryatDr.Abuba- kar’sSpecialistDentalPractice. Specialist in Restorative Dentistry at Fatima Jinnah Consulting Clin- ics. About the Author Fig. 6. Single Bond Universal application in all cavities. Fig. 7. Adaptation of Filtek™ Bulk Fill Posterior composite after completely placing in molar cavity. Fig. 8. Occlusal anatomy being carved on the molar surface. Fig. 9. Anatomy being carved after complete filling of Filtek™ Bulk Fill Posterior composite in both premolars. Fig. 13. Completed restorations. Fig. 4. Selective etching done on enamel mar- gins. Fig. 5. Single Bond Universal adhesive being applied in the molar cavity. Fig. 10. Finishing of the restorations. Fig. 11. Polishing with 3M Spiral Polishing disc and diamond polishing paste. Fig. 12. Restorations after finishing and polish- ing. Fig. 1. Initial case 1: 44 large carious lesion dis- tally, 45 large carious lesion mesially, 46 mod- erate size lesion occlusally. Fig. 3. Caries has been removed and cavities prepared. Premolars have been separated by sectional matrices and wedge. Fig. 2. Isolation of the affected teeth with rub- berdam. mended to place composite in increments due to a variety of reasons. These include penetra- tion of curing light to a limited depth and placing composite in increments will help reduce the effect of polymerization shrink- age to a certain degree. From a clinician’s point of view this approach is certainly time con- suming and there has always been a desire to fill the cavity in a single increment and get the job done as fast as possible. Considering the demand of the dental practitioners, manufac- turers such as 3M, have now introduced bulkfill composites which can be placed in cavi- ties in a single increment and yet can be cured effectively and have good adaptability and re- duced shrinkage. We tried bulk- fill material in a clinical case in which 3 posterior cavities were filled with Filtek™ Bulk Fill Pos- terior composite. Clinical Case A female patient presented with multiple cavities in her teeth. There was a moderate sized cav- ity in the first molar, the first pre- molar had a large distal carious lesion and the second premolar had caries mesially. We decided to manage the 3 adjacent large cavities in her posterior teeth in 4th quadrant with bulkfill com- posite in a single appointment. Fig. 1 to Fig 13. Conclusion Previously with composites be- ing placed in multiple incre- ments, it would have been quite time consuming and tedious to do a number of such restora- tions in a single appointment. Certainly bulkfill composites made the job easier. Their han- dling and manipulation with instruments are also quite user friendly. With the composites being applied in a single incre- ment, an ideal shade match might not be possible in all situ- ations but in posterior restora- tions the effect can be masked to a certain degree. Overall I would say that bulkfill composites will definitely speed up the work and make things easy for the clini- cian.

Pages Overview