Direct composite restoration with 1 shade of Bio Function
– clinical case by Dr. Jun Iwata
Step 1
Rubber dam is placed to provide isolation, followed by cavity preparation and cleaning of the tooth surface.
Step 2
Preparation in slightly over-filled using Bio Function Enamel BF1.
Step 3
An instrument is used to form the cusp angle and remove an overfilled composite.
Step 4
Rough design and position of cusp and ridge, following by rough creation of fissure.
Step 5
A small amount of Dark Brown stain is applied using a file.
Step 6
Post-operative image.
Direct composite restoration with layering of Bio Function
– clinical case by Dr. Andres Roman
Step 1
Pre-operative.
Step 2
Pre-operative lingual view (note the gingival condition due to the loss of tooth structure).
Step 3
Anterior rubber dam clamp is modified for adaption to the case.
Step 4
Isolation with rubber dam.
Step 5
Following adhesive procedure, application of a small amount of Bio Function Dentin (BD5), while leaving space for an enamel thickness needed in the lingual area (0.3mm).
Step 6
Lingual application of Bio Function Enamel BF1 (0.3mm).
Step 7
Application of Bio Function Dentin BD4 on the dentine base creating the cusp.
Step 8
Dentine cusp is covered with Bio Function Enamel BF1 on the lingual area; Bio Function Dentin BD4 is applied to the occlusal side following the natural dentine shape to create the final enamel layer.
Step 9
Occlusal layer is completed with Bio Function BF1 from cusp to cusp, followed by application of BROWN stain.
Step 10
Post-operative mesial view.
Step 11
Occlusal check.
Step 12
Final post operative.
Step 13
Final post operative.
Step 14
Final post operative.
Indirect composite restoration with Bio Function
– clinical case by Dr. Pablo Santoro
Step 1
Pre-operative. 46 y.o. patient with periodontal pain and lack of contact points. Hyperemic pain on tooth 15.
Step 2
Anaesthesia in the upper right quadrant, old restorations are removed. Caries are removed.
All undercuts are filled with a highly filled flowable composite. Teeth are prepared using a classical inlay preparation (flat floor, walls slightly divergent and internal rounded corners). Vestibular wall of tooth 15 presented vertical cracks and its thickness was less and 2mm; for this reason, cusps are covered to achieve the needed thickness.
Finishing the preparation, dentine is sealed to reduce gaps after cementation, increase adhesion values, and to reduce post-operative sensitivity, bacteria micro infiltration and dentine contamination.
Step 3
Impression is taken with a silicone medium and light to create the work models for multiple restorations.
Step 4
Three restorations are created using the Simple Stratification Technique (Técnica de Estratificación Simple -TES) a technique developed by us, where we only use two composite shades (a hyperchromatic dentine and a translucent enamel).
Step 5
All the indirect restorations were polished following a protocol based on a first step of correction with stones, multiblade burs and rubber points and a second step of polishing with silicon points, hair goat brushes and felt wheels.
Step 6
After the try-in, the internal parts of the inlays where sandblasted with 50 micron aluminium oxide for 10 seconds at a distance of one centimetre. 37% etching gel was applied for one minute to eliminate contamination. The restorations were rinsed and dried carefully. An adhesive coat was applied spread with gentle air was spread with air.
Step 7
For clinical cementation, the field was isolated; preparations were etched and dental adhesive was placed. The adhesive layer was spread with air with low pressure to avoid undesired thicknesses that could interfere with the sitting of the inlays.
Step 8
The restorations were cemented from distal to mesial. We cemented using heated composite, as all inlays had a minimum thickness (2mm for inlays on teeth 16 and 14, and 2,5 mm for the inlay on tooth 15). This technique using light-cured composite allows for longer working times and use of an interface of the same material used to made the restorations.
Step 9
(Immediate post-operative) We carefully cleaned the interproximal spaces, removed the rubber dam and checked the occlusion. We did the needed adjustments and we polished all the surfaces with silicone points. We completed with a 2-minute polymerization of each tooth surface
Step 10
2 year follow up.
