PAEDIATRIC DENTISTRY - 3rd Ed. (2005)

(John Hannent) #1

layer of composite will be required to mask the intense stain.



  1. If a tooth is already instanding or rotated, its appearance can be enhanced by a
    thicker labial veneer.


New generation, highly polishable, hybrid composite resins can replace relatively
large amounts of missing tooth tissue as well as being used in thin sections as a
veneer. Combinations of shades can be used to simulate natural colour gradations and
hues.


Indications


(1) discolouration;
(2) enamel defects;
(3) diastemata;
(4) malpositioned teeth;
(5) large restorations.


Contraindications


(1) insufficient available enamel for bonding;
(2) oral habits, e.g. woodwind musicians.


Armamentarium


(1) rubber dam/contoured matrix strips (Vivadent);
(2) preparation and finishing burs;
(3) new generation, highly polishable, hybrid composite resin;
(4) Soflex discs (3M) and interproximal polishing strips.


Technique



  1. Use a tapered diamond bur to reduce labial enamel by 0.3-0.5 mm. Identify the
    finish line at the gingival margin and also mesially and distally just labial to the
    contact points.

  2. Clean the tooth with a slurry of pumice in water. Wash and dry and select the shade
    (538HFig. 10.7 (a)).

  3. Isolate the tooth either with rubber dam or a contoured matrix strip. Hold this in
    place by applying unfilled resin to its gingival side against the gingiva and curing for
    10 s (539HFig. 10.7 (b)).

  4. Etch the enamel for 60 s, wash, and dry.

  5. Where dentine is exposed apply dentine primer.

  6. Apply a thin layer of bonding resin to the labial surface with a brush and cure for
    15 s. It may be necessary to use an opaquer at this stage if the discolouration is
    intense.

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