Dentaltown November 2020 - 53
Fig. 19
little or no microleakage took place, and
microtensile bond strength increased the
dentin in cavities with high C-factor.
Another layer of composite was applied
(Fig. 23, p. 54). The final buildup was done
with a prewarmed restorative composite
(Tetric EvoCeram, Ivoclar Vivadent) to
increase durability.19 Tints (Color Plus) were
placed to create a tertiary anatomy (Fig. 24,
p. 54), then light-cured. After removing
the rubber dam, the occlusion was adjusted
and remained with light centric contacts.
The pointy cusps of opposing teeth were
smoothed to reduce tensile forces.20
Next, the restoration was contoured,
then polished with an intraoral polishing
paste (DiaShine) using a latch brush. A light,
continuous contact is kept to provide a higher
surface luster. A sealant layer (OptiGuard,
Kerr) was applied to seal the small cracks
from finishing procedures (Fig. 25, p. 54).
As a preventive measure for occasional
bruxism, the patient was provided with a
personalized night guard.15
The restoration has kept up at its 10-year
follow-up, demonstrating an absence of any
crack extension into the pulpal floor (Fig. 26,
p. 54). As in Case 1, the only thing I'd do
differently today would be to use Ribbond
Securing Composite, for easier placement
and ideal adaptation of Ribbond fibers to
the teeth.
Discussion
A cracked tooth can act as a pathway
Fig. 20
for bacteria that may induce pulpal or periapical inflammation or disease.21 Complex
restorative and endodontic treatments that
remove dentin compromise the internal
strength of the tooth, making it susceptible
to fracture.22 Cracked teeth are common
and challenging 23, and may be caused
by excessive forces from mastication or
malocclusion. Large or normal forces could
weaken the tooth.24
The multidirectional Ribbond fibers
bridging the crack act like basket-woven
stitches that transfer stress to a region of
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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
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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
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Dentaltown November 2020 - 53
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Dentaltown November 2020 - 80
Dentaltown November 2020 - Cover3
Dentaltown November 2020 - Cover4
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