Anterior composite Dr. Ali Mohammed

Anterior composite

1. Anterior Composite BY: Ali Mohammed Mahdi Ali Adnan Jasim

2. The Anatomy of Anterior Teeth

3. Central incisors Upper central incisor lower central incisor

4. Lateral incisors Maxillary lateral incisor Mandibular lateral incisor

5. Canine Maxillary canine Mandibular canine

6. In composite, there are some characteristics you must restore!

7. Primary characterization Tooth outline(shape) Incisal angle Incisal edge

8. secondary characterization (VERTICAL ) Lobs Transitional line Groove

9. Tertiary characterization (horizontal ) lines of Retzius

10. TYPES OF COMPOSITE According to the translucency

11. The tooth is compose of two layers : Enamel and Dentine Dentine is opaque while the Enamel is translucent And according to these we have three type of composite: Enamel , Universal dentine and Opaque dentine . Enamel \ trans Dentin-universal \Medium opacity Opaque-dentin \ High opacity

12. The layering system in composite Two layer of composite Enamel \ trans As deep layer Final layer Three layer system composite Enamel \ trans As middle layer Final layer Opaque-dentin \ High opacity As deep layer

13. Restoration of CL III, IV and V

14. Restoration of CL III Class III- Smooth surface, involves proximal surface of anterior tooth. Clinical Technique for Cla ss III Direct Composite Restoration Cavity preparation Isolation Etching Bonding Composite application Finishing and polishing

15. Cl III Cavity Preparation 1-Conventional Class III Tooth Preparation primary indication for this type of Class III preparation is for the restoration of root surfaces, preparation the portion on the root surface that has no enamel. Box-like design placement of a retention groove (if necessary )

16. Cl III Cavity Preparation 2-Beveled conventional Class III Tooth Preparation The beveled conventional tooth preparation for composite restorations is indicated primarily for replacing an existing defective restoration in the crown portion of the tooth. 3-Modified Class III tooth Preparation A modified tooth preparation is the most used type of Class III tooth preparation. It is indicated for small and moderate lesions or faults and is designed to be as conservative as possible The preparation design appears to be "scooped" or concave, the cavosurface margins in a beveled configuration So why the bevel?!

17. According to studies Beveling the enamel margin has benefits as well. It increases the surface area for retention , improves esthetics , and enhances the marginal seal Soliman S, Preidl R, Karl S, Hofmann N, Krastl G, Klaiber B. Influence of cavity margin design and restorative material on marginal quality and seal of extended class II resin composite restorations in vitro. J Adhes Dent. 2016 Jan 1;18(1):7-16. The interface between the composite restoration material and tooth structure showed maximum tensile stresses during simulated occlusal forces when tooth was prepared without the bevel. This could potentially lead to bond failure between resin composite and tooth structure. Whereas by using the bevel the tensile stresses were eliminated in the tooth structure dental material interface. Apel Z, Vafaeian B, Apel DB, Hussain A. Occlusal stresses in beveled versus non-beveled tooth preparation. Biomedical Engineering Advances. 2021 Dec 1;2:100010.

18. Cl III Cavity Preparation CASES

19. Case 1

20. To get the best anatomical fit to the proximal area, the matrix can be modified.

21. A flowable composite is placed in a thin layer and we press the matrix with the finger on the buccal side before light-curing. Then, a small amount of enamel composite is placed to restore the proximal wall.

22. Then the rest of the cavity can be filled. Although, in this case, only an enamel shade was used, a body material can be very useful for this kind of cavities

23. Next we go with the centrals. For a good management of the space between the centrals, two matrices are placed at the same time. The position is very important in order to create a restoration as close as possible to the natural shape of the proximal area. The first central was restored starting with enamel as composite. Also a body material could have worked very nicely.

24. Both matrices were removed to finish the first restoration. At this stage finishing of the first restoration is better than doing it at the end, because we have a plenty of room and also to manage the proximal shape properly. The proximal is finished. If the proximal area of the neighboring tooth is well designed, creating the contact point and fitting the matrix will be easier.

25. The same procedure was used for the other cavity.

26. Cl III Cavity Preparation Case 2 Unica is the simple and ideal matrix for anterior restorations such as class III, IV, V, direct stratification composite veneers, and shape modifications.

27. Restoration of CL IV Class IV tooth preparation is indicated for restoring proximal areas that also include the incisal surface of an anterior tooth. 1- Beveled Conventional Class IV Tooth Preparation: The beveled conventional Class IV tooth preparation is indicated for restoring large Class IV areas 2-Modified Class IV Tooth Preparation: The modified Class IV preparation for composite is indicated for small or moderate Class IV lesions or traumatic defects. Clinical Technique for Cla ss III Direct Composite Restoration Cavity preparation Isolation Etching Bonding Composite application Finishing and polishing

28. Restoration of CL IV CASES

29. Case 1

30. Case 2

31. Case 3

32. Restoration of CL V Class V tooth preparations, by definition, are in the gingival one third of the facial and lingual tooth surfaces. Conventional Class V tooth preparation: A lesion entirely on root surface. Beveled Conventional Class V Tooth reparation: The beveled conventional Class V tooth preparation ha margins and is indicated either for: (1) The replacement of defective Class V restoration or (2) For a large, new carious lesion Modified Class V retention form Tooth Preparation: The modified Class V tooth preparation is indicated for the restoration of small and moderate Class V lesions or defects.

33. Restoration of CL V CASES

34. Case 1

35. Case 2

36. Case 3

37. To test the gum compression To test the proper size

38. Thankyou