Dentaltown November 2020 - 51

high-strength polyethylene fibers (Ribbond)
blotted with an unfilled bonding adhesive.
Excess was removed with lint-free gauze.
The fibers were fi rmly inserted into the
uncured composite in the mesial-distal
direction (Fig. 11). The other piece of highstrength polyethylene fibers was tightly
introduced onto the uncured composite in
the buccal-lingual direction (Fig. 12). The
fibers were adapted and pressed (Fig. 13) as
close to the pulpal floor as possible, then
light-cured. This increment will be the
base or liner (Fig. 14). Lastly, the thickest
increment was applied with the same bulk
composite.
Tints (Color Plus, Kerr) were placed to
create tertiary anatomy (Fig. 15). Glycerin
was placed on all surfaces to avoid the
oxygen inhibition layer, ensuring total
polymerization of the composite, then

Fig. 9

Fig. 10

light-cured14 (Fig. 16, p. 52). The rubber dam
was removed and occlusion was inspected
in all eccentric movements to avoid any
premature contact.
Then, the contoured restoration was
polished with intraoral polishing paste
(DiaShine, VH Technologies), using a
latch brush and keeping light in constant
contact with the restoration. This provides
higher surface luster (Fig. 17a, p. 52). As a
preventive measure for occasional bruxism,
the patient was provided with a night guard.15
A postoperative periapical X-ray was taken
(Fig. 17b, p. 52).
We explained to the patient that this is
a temporary aesthetic fi x, done to facilitate
further treatment planning. It does not
represent a definitive treatment solution. So
far, the restoration has survived an eight-year
follow-up (Fig. 18, p. 52). We did not find

the presence of crack extension into the
pulpal floor. To this day, the patient has
decided to leave the restoration untouched.
At this time, the only part of the treatment I'd do differently today would be to
use Ribbond Securing Composite, only
because it is ideally used for Ribbond fiber
adaptation. It also allows for easier placement.

Fig. 11

Fig. 13

Fig. 12

Fig. 14

Fig. 15

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Dentaltown November 2020

Table of Contents for the Digital Edition of Dentaltown November 2020

Dentaltown November 2020 - Intro
Dentaltown November 2020 - Cover1
Dentaltown November 2020 - Cover2
Dentaltown November 2020 - 1
Dentaltown November 2020 - 2
Dentaltown November 2020 - 3
Dentaltown November 2020 - 4
Dentaltown November 2020 - 5
Dentaltown November 2020 - 6
Dentaltown November 2020 - 7
Dentaltown November 2020 - 8
Dentaltown November 2020 - 9
Dentaltown November 2020 - 10
Dentaltown November 2020 - 11
Dentaltown November 2020 - 12
Dentaltown November 2020 - 13
Dentaltown November 2020 - 14
Dentaltown November 2020 - 15
Dentaltown November 2020 - 16
Dentaltown November 2020 - 17
Dentaltown November 2020 - 18
Dentaltown November 2020 - 19
Dentaltown November 2020 - 20
Dentaltown November 2020 - 21
Dentaltown November 2020 - 22
Dentaltown November 2020 - 23
Dentaltown November 2020 - 24
Dentaltown November 2020 - 25
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Dentaltown November 2020 - 29
Dentaltown November 2020 - 30
Dentaltown November 2020 - 31
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Dentaltown November 2020 - 34
Dentaltown November 2020 - 35
Dentaltown November 2020 - 36
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Dentaltown November 2020 - 39
Dentaltown November 2020 - 40
Dentaltown November 2020 - 41
Dentaltown November 2020 - 42
Dentaltown November 2020 - 43
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Dentaltown November 2020 - Cover3
Dentaltown November 2020 - Cover4
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