Class III Composite Resin Restoration

From the Clinic Manual

Jump to: navigation, search

Preparation

Outline form is determined by the extent of caries.

  1. Lingual approach unless facial surface is already cavitated by caries (use 330 of #2 round bur).
  2. Labial extension as minimal as possible (just breaks contact).
  3. Incisal proximal contact shouldn't be broken unless carious.
  4. Gingival proximal contact is to be broken.
  5. Axial wall follow the external contour.
    • Caries dictates final depth.
  6. The need for enamel bevels has not been clearly demonstrated, but narrow bevels (0.5 to 1.0 mm) may be placed on accessible enamel margins to remove fragile enamel.
  7. Preserve facial enamel unless carious. Unsupported non carious enamel on facial wall is acceptable.
  8. Facial access may be indicated if involved or teeth are overlapping teeth prevent lingual access. In this case, the labial access should be in line with the enamel rods and the lingual extension just breaks contact.

Ideal Prep Design

  1. Lingual access with a #2 round or 330 pear shape in line with the enamel rods. (See diagram)
  2. Labial extension just breaks contact
  3. Incisal proximal contact shouldn't be broken unless decay extends to this area
  4. Gingival proximal contact is to be broken
  5. Axial wall parallel to pulp ideally 0.2mm from DEJ in dentin
    • Caries usually dictates final depth
  6. Converging walls will be created by #330 or #2 round giving good retention and are acceptable
    • Remove any friable enamel
    • Unsupported ename, especially on labial, is acceptable

Note: If decay dictates a labial access, then the labial access is in line with the enamel rods and the lingual extension just breaks contact.


Restoration

  • Place clear matrix and wedge
  • Etch enamel and dentin with 35% phosphoric acid for 15 seconds.
  • Rinse and remove all water. Keep dentin moist.
  • Scrub etched surfaces with 1 step bonding argent for 20 seconds. Lightly thin the bonding agent
  • Light cure for 10 seconds
  • Small lesion: may be filled in one increment and cured for 40 seconds
  • Larger lesion: restore incrementally
  • Try not to overfill to minimize finishing

Finishing and Polishing

  • Remove gingival flash using #12 scalpel blade or a sharp guettro knife
  • Contour the restoration with a finishing bur, diamond or disk
  • Use polishing strips to contour and polish proximal surface and margin
  • Polish using impregnated rubber tips
  • Rebonding: Etch restoration and margins and seal with optiguard or sealant
Retrieved from "http://dental.case.edu/wikiclinic/index.php/Class_III_Composite_Resin_Restoration"