Complex direct ORMOCER composite restorations
Fig. 1: Pre-operative situation showing large restorations and minimal residual tooth structure.
Fig. 2: Completed preparation with strongly bevelled margins as an alternative to straight cuspal height reduction. The cusps were at least 3 mm thick at their base.
Fig. 3: The teeth were micro air abraded using 27 micron aluminium oxide. A selective enamel etch technique was then applied using Futurabond U. The lingual cusps were built-up with a purely ceramic-based bulk fill ORMOCER.
Fig. 4: The marginal ridges were built-up using a sectional matrix system (V3, Triodent, Dentsply Sirona). In this fashion, we have converted a complex Class II into a Class I situation.
Fig. 5: The buccal lobes were built-up individually, starting with the mesiobuccal lobe.
Fig. 6: After all buccal lobes were fully cured, FinalTouch brown shade (VOCO) was added to the base of the lobes as part of the Tam interlobe staining technique.
Fig. 7: The mesiolingual cusp was shaped and finished with a brush to create the infoldings into the mesiolingual and mid-lingual lobes. The brown stain was partially covered and thus giving a natural appearance.
Fig. 8: The distolingual cusp was shaped and finished with a brush to create the infoldings into the other surrounding lobes and to complete the occlusal surface. The shade is extremely natural.
Fig. 9: Immediate post-operative situation before application of hypomineralisation details on triangular ridges.
Fig. 10: Situation after application of hypomineralisation details to the triangular ridges using FinalTouch white.
Fig. 11: Final post-operative situation showing light centric point contacts, free of functional lateral excursive interferences, and with full aesthetic integration.
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