Dentaltown September 2017 - 78
Case study
A 24-year-old patient with a history of moderate/severe caries
profile, fair hygiene and a poor track record of keeping his dental
appointments presented with MO decay in #18 (Figs. 1 and 2).
I decided to use Ionolux by Voco as an RMGI liner, in an open
sandwich technique (Fig. 3), instead of a closed sandwich technique
(Fig. 4) with Admira Fusion by Voco as the composite capping
material. I opted for Ionolux because it's manufactured with a pure
form of polyacrylic acid. With the ionic exchange mechanism of
adhesion which is characteristic of RMGIs, a superior bond strength
to the tooth is achieved. This entirely eliminates the need for an
adhesive, which can save clinicians valuable time.
(Because of Ionolux's inclusion of a pure form of polyacrylic
acid, as mentioned above, the use of a dentin conditioner is not
required; nevertheless, clinicians may include this step for the sake
of scrupulousness, as long as a mild conditioner is used.1)
Unlike composite resins, which are the typical selection of most
clinicians, RMGIs are inherently hydrophilic, which make them
good candidates for scenarios in which isolation may be problematic.
Fig. 1
Fig. 2
In fact, clinicians must take care not to overdesiccate the target area
when using an RMGI; otherwise, they run the risk of impairing
the physical properties of the material.
After preparation and isolation of the Class II restoration was
accomplished with the Palodent Plus matrix system from Dentsply
Sirona (Fig. 5), the RMGI was placed into the proximal box (Figs. 6
and 7) and light-cured for 20 seconds. Once cured, the tooth was
conditioned with 32% Uni-Etch phosphoric acid etchant from
Bisco (Fig. 8). Futurabond DC bonding agent from Voco was placed
and light-cured for 20 seconds (Fig. 9).
Admira Fusion (Fig. 10) was then placed in 2-millimeter
increments and contoured; the rubber dam was removed and proper
occlusion was obtained. Finishing and polish was accomplished
with a single-use composite polishing system from Darby Dental
(Fig. 11). The resulting restoration (Fig. 12) provides a predictable
and long-term solution that affords both patient and clinician peace
of mind for years to come.
Fig. 3
Fig. 4: Closed sandwich technique
Composite
Composite
GIC
GIC
Enamel
GIC exposed to oral cavity
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 11
Fig. 12
78
SEPTEMBER 2017 // dentaltown.com
Fig. 9
Fig. 10
http://www.dentaltown.com
Table of Contents for the Digital Edition of Dentaltown September 2017
Dentaltown September 2017 - Intro
Dentaltown September 2017 - Cover1
Dentaltown September 2017 - Cover2
Dentaltown September 2017 - 1
Dentaltown September 2017 - 2
Dentaltown September 2017 - 3
Dentaltown September 2017 - 4
Dentaltown September 2017 - 5
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Dentaltown September 2017 - Cover3
Dentaltown September 2017 - Cover4
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