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GIUSEPPE MARCHETTI

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DEEP MARGIN ELEVATION, INDIRECT AND
DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE
20104 Views - Sep 2012

indirect and direct composite restorations a clinical case Giuseppe Marchetti D.D.S., Private practice:
Studio Dentistico Marchetti Parma, Italy, drgmarchetti@hotmail.com

1) Pre-operative

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

2) Rubber dam isolation

3) Rubber dam isolation (Detail Of 3.6)

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

4) Removal of the old and incongrous restoration and of the secondary decay

5) Detail of the cavity distal cusps are reduced because of the lack of supported enamel

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

6) An automatrix is placed for the build-up

7) Enamel is etched for 15 seconds

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CLINICAL CASE

8) Enamel & dentine are etched for other 15 seconds

9) Application of primer and bonding in two steps and hybridization of the dentin

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

10) For ease of impression making and next isolation and cementation a deep margin elevation is done
with an etch and rinse 3 steps techinque and a flow composite

11) Immediate dentine sealing & margin elevation & prep. Of the onlay

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

12) Detail of the impression

13) New rubber dam isolation after one week

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

14) Rubber dam isolation (detail of 3.6 and mesial decay of 3.7)

15) 3.7 is filled before the cementation of the composite onlay of 3.6

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CLINICAL CASE

17) Filling of 3.7 with tunnel technique

18) Filling of 3.7 with tunnel technique, occlusal view

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CLINICAL CASE

19) Fitting of the composite onlay

20) After polishing the build up with air flow, enamel is etched

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

21) Bonding application

22) The onlay is first sandblasted

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

23) Than it is silanized

24) And than it is bonded without curing it

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

26) It is cured for 210 seconds for each surface

27) A first finishing abrasive strip is passed under the contact areas of 3.6

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

28) A burr for reciprocating handpiece is used for the first finishing

29) The old and incongrous filling on 3.8 is removed and a news done.

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CLINICAL CASE

30) New filling on 3.8 (detail)

31) Finally the distal decay on 3.5 is removed

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

32) The cavity is turned from a ii to a i class

33) And a filling is done on 3.5

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

34) 3.5 3.6 3.7 3.8 are cured under glycerine to inhibit the presence of oxygen

35) First a multiblade burr removes the small surplus

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CLINICAL CASE

37) A finishing abrasive strip is passed under the contact areas of 3.5

38) At the end a goat hair brush with cerium oxide is passed to polish all

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CLINICAL CASE

39) The full left posterior arc is restored from 3.5 to 3.8

40) Detail of 3.8

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CLINICAL CASE

41) Detail of 3.8 from a different angle

42) Details of 3.5 3.6

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CLINICAL CASE

43) Details of 3.5 3.6 from a different angle

44) The four restorations polished

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

45) After the rubber dam removal just some little occlusal corrections are needed

46) A final occlusal view, waiting for teeth rehydration

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www.styleitaliano.org - DEEP MARGIN ELEVATION, INDIRECT AND DIRECT COMPOSITE RESTORATIONS, A
CLINICAL CASE

47) After the occlusal corrections both centric occlusion (blue paper) then protrusion and lateral
movements (red paper) are good.

48) Final occlusal view, two month control

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CLINICAL CASE

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