How To Use Dental Opaquer – Posterior restorations require strength, but can also be optimized for performance and aesthetics. Learn how you can improve your results by perfecting your composite placement technique – either in increments or in bulk.
There is no single blueprint for posterior composite restorations. Efficiency, predictability, durability, aesthetics – many factors come into consideration with every choice of material and technique. Many clinicians rely on standard incremental placement, which is well practiced and well known. But mastering one-step placement with bulk filling composites can also pave the way for new opportunities for your practice by improving efficiency without compromising the quality of dentistry your patients deserve.
How To Use Dental Opaquer
Incremental placement of composites is usually performed to reduce the effects of shrinkage stress due to polymerization or to improve esthetics. Sometimes this means simply performing a “ramp fill”, where either the buccal or lingual prep wall is filled and light-cured in steps. Alternatively, Class II restorations can be placed by restoring the proximal boxes and marginal ridges first, followed by gradual filling of the occlusal areas.
Ml Gc Gradia Gum Opaque
Bulk filling has multiple advantages, including the potential for fewer voids and reduced time and complexity compared to incremental composite placement. Older generations of bulk fill composites were not as esthetic as they required transparency to achieve a great depth of cure. They also showed high polymerization shrinkage and associated stress. Modern bulk fillings, however, allow the placement of posterior composites in increments of up to 5 mm and offer a high degree of reliability in the depth of material hardening (using three-point hardening) without the increased risk of postoperative sensitivity.
Flowables are particularly useful for deep posterior Class 1 or Class 2 restorations. A deep preparer – often in a proximal box – can be flowable and cured to allow you to meet the cure depth requirements for your bulk fill composite, which in my case is 5 mm. But that’s not the only time you can benefit from using liquid composite.
In my practice, I use flowable materials on every posterior restoration. Partly because it is very difficult to gain access to the proximal box with the tip of the capsule. And injecting a viscous restorative material directly from the capsule can limit the fit of the composite when irregular cavity shapes are present—especially if the preparation involves 90° angles. Irregularities and sharp angles can leave gaps and cavities in the interspace of tooth restorations. Liquid allows you to fill in micro-irregularities before gradually layering up to occlusion.
I most often use the “snowplow” technique, placing a thin layer of liquid on the bottom of the pulp first – without curing – followed by placing bulk fill or universal composite over the top with pressure. This allows the fluid to fill all corners, cracks and irregularities within the cavity preparation. Although two different restorative materials are placed one after the other, it is not actually considered layering or incremental placement, since both cure simultaneously.
Point 4 Unidose A2 Opaque 20 X 0.20gm
Patients today want healthy, natural-looking teeth – even beyond the anterior aesthetic zone. As we strive to maximize the aesthetics of the rear end, attention to detail is important. For this purpose, I use an opaquer whenever an amalgam tattoo or stained dentin is present. First, because the gray color of the amalgam tattoo may look like secondary caries to you or another dentist and may result in unnecessary composite replacement. In addition, patients invest both time and money in their oral health, so it is understandable that they do not want to see discoloration under a newly placed composite.
In my practice, we use 3M™ Filtek™ Supreme Flowable Restorative shade AO3 or 3M™ FIltek™ Universal Restorative Pink Opaquer if we need to block underlying discoloration. It’s important to note that opaques aren’t just for aesthetics – this step helps eliminate future guesswork or rework due to color change. Opacifiers also help keep patients satisfied with the aesthetics of their new filling. For these reasons, I always block out any stains or dark tooth structure when placing posterior composites.
Some clinicians find it difficult to adjust to bulk restorations because they are used to incorporating occlusal anatomy during incremental placement. They hypothesize that bulk filling will require reduction of the hardened composite to form the correct anatomy. However, this is not the case with modern materials.
In my practice, we always try to sculpt the occlusal anatomy into our restorative material prior to light curing, rather than cutting it with burrs to occlusion. 3M™ Filtek™ One Bulk Fill Restorative makes this possible – it’s a little softer than some universal restoratives, but it’s not sticky, making it easy to carve and adjust. Most clinicians are well trained in carving anatomy using amalgam, and these skills can easily be transferred to bulk fillings – allowing you to take advantage of the fact that very little finishing is required after placement, shaping and curing.
Step By Step Guide: How To Block Out Metal Using Pink Opaquer
If you are more comfortable with the incremental fill technique, I recommend applying a layer of liquid material and spreading it to fill any corners or irregularities in the preparation, making sure to cover the entire bottom of the pulp. After the liquid has set, place one addition of composite as a ramp on the buccal side and cure, then add and cure another ramp on the lingual side. Basically, you fill one side of the restoration first and then the other, avoiding placing increments that connect the cusps and curing each increment as you go. Start at the bottom of the pulp and work your way up, drying each side separately – never all at once. This helps alleviate polymerization shrinkage and “factor C” stress, reduces postoperative sensitivity, and improves the adaptation of the restorative material to the tooth.
In order to achieve a successful depth of cure, you not only need to know and trust your materials, but you need confidence in your equipment and technique. Many clinicians do not trust bulk fillings because they are not sure they will heal completely, so choose a material you can trust. Filtek One Bulk Fill Restorative, for example, has a proven cure depth of 5mm when using the 3-position cure technique. However, the ability to achieve full cure often has less to do with the properties of the composite and everything to do with your light or curing technique.
Frankly, some clinicians have lights that just aren’t high quality or bright enough. If the composite is not completely hardened, it may change color, wear out prematurely, and in some cases the patient may experience post-operative sensitivity. Many dentists are either unaware of the inefficiency of their light or end up over-polymerizing for peace of mind. That’s why it’s so important to regularly maintain and test your curing lights. It’s easy enough to check your equipment using systems like BlueLight CheckUp and CheckMARC – professional resources and test equipment designed to help keep your equipment running at its best. Most of all, regular testing can help you build confidence in your light and confidence in your abilities, so you can feel more comfortable with bulk charging.
If you haven’t yet implemented bulk fill materials, it’s a good place to start to improve your efficiency and reduce your desk time. The use of universal adhesives is also a great addition to your posterior procedure as no additional sensitivity control steps are required – they are excellent at penetrating and creating an excellent hybrid layer, sealing the dentin, resulting in very low post-operative sensitivity.
Dental Flowable Composite Beautifil Opaquer 2gm Syringe With 5 Needle Tips By Shofu
Etching has been shown to improve adhesive bond strength, especially on enamel – and so I always fully etch unless we are close to the pulp. In addition, it is often difficult not to nick the dentin when etching the enamel margins. Begin by placing the etching on the enamel surfaces, then cover the dentin and wash after 5 seconds.
In the past, patients were not too concerned about the aesthetics of their back teeth, but attitudes have changed. Most of my patients want their entire smile, from front to back, to look and feel great. And although often overlooked, the finishing and polishing steps of a posterior restoration are critical to ensuring esthetic, long-lasting results. In addition to improving gloss and polish, finishing and polishing can actually prevent staining and improve color stability.
Polishing requires a series of progressively finer grains. One way to think about polishing is that you are actually scratching the surface and you want to continue to remove the scratches in succession until all the scratches are gone – resulting in a silky smooth surface shine that resists staining and plaque retention.
I always recommend using diamond-impregnated rubber tips, cups, discs or brushes, Medium and Fine. The 3M™ Sof-Lex™ Diamond Polishing System is great because it’s a two-step process. For anterior restorations, we take it a step further on the anterior teeth and use a polishing paste with a felt disc or a small brush or cloth wheel to achieve the desired shine. And of course, you need to make sure you use material that complements your process. In my experience, nanocomposites provide excellent handling, high strength, low wear, with excellent gloss and gloss retention. Due to its nano-sized filler particles,
