DentaltownUK June 2018 - 30

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I Hate Class III Composites
This Townie is fed up and frustrated! Luckily, dozens of his peers weigh in with
advice and product recommendations to make treatment more manageable

NomNom Chompsky
Member Since: 01/12/11
Post: 1 of 61

Title says it all. I've read every thread on DT I could find to get more efficient, but I still
dread them, especially when the decay wraps around onto the facial or lingual.
I saw a girl today who has Class IIIs on all teeth from #6-11, with separate or connecting
Class Vs. It took me about an hour and a half just to do 9MDFL, 10MDFL, 11MF.
I've tried Satch's single-tooth isolation, Greater Curve band, and good old-fashioned Mylar
strips. Seems like there needs to be a better way. n
8/2/2018

Richy
Member Since: 30/03/10
Post: 2 of 61

I enjoy Class IIIs. Here are some pointers; I'd be happy to give more tips, so ask away.
I access from the lingual using a flat-end diamond bur. I start at the contact and prep out
going as far apical as needed. Leave a thin shell of facial enamel intact. Then place a Mylar strip
between the teeth and a wedge. I prefer the Garrison plastic wedges (3D wedges, I think).
Condense very small increments into the prep. After curing, pop off the Mylar and wedge;
the wedge will have prevented excess from going sub-g. Finish with a football and a flame.
If the prep extends facially, when you place the Mylar, fold it over the facial opening, hold
it there, and place composite against it and cure it from facial for a few seconds, then finish as
normal.
If there are two adjacent lesions, prep them both. Restore the smaller one first, then the
larger. n
8/2/2018

palmers31
Member Since: 30/07/08
Post: 7 of 61

When things get stressful, remember the KISS rule.
I limit myself to no more than six surfaces per visit. I found any more than that and I start
getting grumpy and my quality goes down. For six surfaces I give myself an hour and a half, but
I rarely do six surfaces at a time. Usually it's 2-4 surfaces in one-hour appointments.
I use Mylar strips and OptraGate for my retraction. Keep some Stat Gel handy (make sure
to "power rinse" it thoroughly) and make sure the Mylar strip is into the sulcus on the facial and
lingual. This is really important! It's also important to place your wedge quite a bit apical to your
prep (hard to explain ...).
Take your time, bevel your margins, and don't stress. Bioclear matrix works well too, but
they're a tad unnecessary if you've got good technique with a Mylar.
Have fun! n
9/2/2018

NomNom Chompsky
Member Since: 01/12/11
Post: 8 of 61

I love this advice, but when reimbursement for a Class III (MFL or DFL) is only $110, it's
tough not to stress.
Let's say a tooth has an MF on one side and DL on the other-does anyone have a technique
for restoring both at the same time? Access on one using Mylar blocks access to the other. n
9/2/2018

Timmy G
Member Since: 14/04/02
Post: 10 of 61

I find the VariStrips from Garrison are really handy to have on hand as well. They are
contoured and can make a huge difference.

JUNE 2018 // dentaltownuk.com

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