Cosmetic Tribune U.K. Edition

17Cosmetic TribuneApril 2014United Kingdom Edition Early Bird oﬀer – 20% oﬀ if booked before May 15, 2014. See website for details In the Co-Cure Technique, the composite restoration does not require a bonding agent be- cause the bonding agent is es- sentially the RMGIC. The RMGIC acts as the interface between the GIC and the composite material. It combines the GIC, RMGIC and composite in a way to form what can best be described as a ‘mon- olithic biomimetic restoration.’ This restoration is an ‘open sandwich’ type of sandwich technique. That is, the GIC component is exposed to the oral environment (Fig 13) at the gingival portion of the res- toration. It is quickly and effi- ciently accomplished and has significantly reduced postopera- tive sensitivity compared with typical direct RBC techniques. I have been placing these types of direct posterior restorations since 2008. They have become the cornerstone of my practice. Technique procedure (Fig 14) After placement of an appropri- ate dental matrix, the technique incorporates the use of 37 per cent phosphoric acid to pre- pare the tooth for restoration. The acid is essentially ‘flooded’ into the preparation in a similar manner to doing a ‘total-etch’ RBC. It is, however, washed off after five seconds of placement. The tooth is then dried but not desiccated. The area remains slightly moist because the GIC that will be placed next is hydro- philic. Fill the preparation with the triturated GIC material up to the level of the DEJ, then immediately place the triturat- ed RMGIC in a very thin layer to cover the GIC and walls of the preparation. Finally, place the composite over the previ- ous materials to slightly overfill the preparation. With a large round burnisher dipped in an unfilled resin material (ie Riva Coat by SDI or G-Coat by GC), wipe away the excess GIC and composite restoration material to create your margins and pre- vent ditching and white lines. The occlusal table of the res- toration can then be com- pressed gently with a plastic occlusal matrix by either hav- ing the patient bite or by the operator pressing gently with his thumb or forefinger to improve the coalescence of the three materials. This can help reduce the time involved in creating the final occlusion of the restoration by creating a functional occlusal table. The restoration is then cured for 30 to 40 seconds with an LED curing light that gen- erates at least 1,500mW/cm2 . Appropriate light output is critical for all direct cured res- torations, and assurance that appropriate output is provided by the curing light is needed Fig 8 page 18DTà Fig 9 Fig 10

Cosmetic Tribune U.K. Edition

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