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20 RESTORATIVE Dental Tribune Middle East & Africa Edition | 3/2018 Large MODL Class II restoration with ceram.x® SphereTEC one, Palodent® V3 and SDR® Plus By Dr. Clarence Tam, New Zeland A 43 year old female came to my practice with a history of non-attendance. She was concerned about generalised sensitivity with her heavily-restored dentition, many teeth of which featured extensive com- posite restorations with recurrent caries detectable both clinically and radiographi- cally. Certain teeth with extreme structural compromise were planned for bonded porcelain restorations, however, restora- tions like this large MOD were planned to be restored with direct composite due to financial constraints. Conclusion and references Following the total etch bonding tech- nique, Dentsply Sirona’s SDR® Plus was placed against the base of the proximal box floor as liner in very thin layers and cured, in an effort to ensure hybridisation and marginal integrity in this sensitive area before building the marginal ridge. The body composite chosen, Dentsply Si- rona’s ceram.x® SphereTEC™ one, features SphereTEC™ technology using spray gran- ulation to produce spheres with a mean size of 15 µm out of primary submicron fill- er glass. These spheres minimise frictional forces when under stress. On the other side, the irregularly shaped primary particles ensure high slump resistance, thus leading to excellent sculptability. The Cloud Shad- ing Concept adopted by Dentsply Sirona’s ceram.x® SphereTEC™ one allows a single shade to umbrella a cluster of shades, by its distinct chameleon effect, permitting a minimalised armamentarium. The Palodent® V3 matrix permitted ef- ficient reconstruction and placement of initial layers in the extended proximal box situation, obviating the need to free-hand sculpt line angles prior to placement of the sectional matrix assembly. All in all, the Class II Solution™ offered by Dentsply Sirona is elegant, efficient and precise; three features I strive to achieve in every restoration. Dr. Clarence Tam Auckland, New Zealand. Clarence is the Chairper- son and Director of the New Zealand Academy of Cosmetic Dentistry. She is currently one of only two individuals in Australasia to hold Board-Certified Accredited Member Status with the American Academy of Cosmetic Dentistry. Clarence is a Key Opinion Leader for multinational dental compa- nies Kuraray Noritake, J Morita Corp, Hu-Friedy, Henry Schein, Ivoclar Vivadent, Dentsply Sirona, Kerr, GC Australasia, SDI, Coltene, Triodent and is the only Voco Fellow in Australia and New Zea- land. She holds Fellowship status with the Inter- national Academy for DentoFacial Esthetics. She sits on the Board of Smiles For the Pacific, an edu- cational trust and charity for dental professional development across the South Pacific. Before - Intraoperative situation showing extent of large MODL Class II restoration. Resin-modified calcium silicate liner placed against area of deeper dentin with near-cari- ous pulp exposure. Wedgeguards will protect against ac- cidental adjacent tooth grazing during preparation, and also double as the wedge for the Palodent® V3 sectional matrix assembly. Palodent® V3 sectional matrix set-up showing a re-cre- ation of an ideal line angle anatomy all in one solution. Zoomed out view showing diametrically-opposing Pal- odent® V3 rings with Palodent® V3 matrices overlapping each other in a one-step solution driving the rebuilding of proximal and axial contours predictably. Marginal ridge formation using A2 ceram.x® SphereTEC™ one. Removal of sectional matrix assembly after this stage. Finish like a Class I restoration. Buccal lobe placement using A2 ceram.x® SphereTEC™ one. Fissure stain placed in interlobar position. After - Final result after placement of lingual lobe and characterisation. This result demonstrates the superb handling, sculptability and chameleon effect of the uni- versal, cloud-shaded ceram.x® SphereTEC™ one compos- ite featuring spherical fillers for ultimate control of place- ment. Note the precision of line angle and bucco-lingual embrasure formation with Palodent® V3.