Dental News - Replacement of a faulty posterior restoration

Dr Sushil Koirala, Nepal

Wed. 6. May 2009

save

A 21-year-old male patient presented complaining of sensitivity and mild pain when chewing on tooth #36. During examination, an under filled tooth with poor marginal seal and marginal discoloration was visible. The peri-apical radiograph indicated secondary caries.

After careful removal of the faulty composite restoration, the cavity was treated with the fluoride-releasing bonding system Fl-Bond II and restored with Beautifil Flow as a base and Beautifil fluoride-releasing materials (all SHOFU). Effect colours were used on the occlusal surface to mimic the adjacent tooth.

The main challenges in this case were the removal of the faulty composite restoration with minimal intervention of the healthy tooth structure and the mimicking of the occlusal anatomy and proper shade.

Figs. 3–5: Isolation of tooth 36 with rubber dam (Fig. 3). Application of self-etching primer on the entire cavity (Fig. 4). Uniform application of bonding agent and subsequent light-curing (Fig. 5).

Figs. 6–8: Application of a thin layer of flowable resin on the cavity floor (Fig. 6). Application of flowable opaque (#UO) to mask the discolouration (Fig. 7). Build-up of the dentin layer, obtaining occlusal anatomy (Fig. 8).

Figs. 9–11: Build-up of the enamel layer and carving of the pits and fissures to achieve natural anatomy (Fig. 9). Application of dark brown stain on the pits and fissures to match adjacent tooth 7, and light-curing (Fig. 10). Checking the occlusal contact with articulating paper (Fig. 11).

Figs. 12–14: Reduction of the high points with Dura White Stone #FL2 (Fig. 12). Note the restored anatomy comparable to natural adjacent tooth (Fig. 13). Restoration after finishing and polishing (Fig. 14).

Editorial note: This article was originally published in Cosmetic Dentistry Vol. 3, Issue 2, 2009.

Contact info

Dr Sushil Koirala, president of the Vedic Institute of Smile Aesthetics (VISA), can be reached at skoirala@wlink.com.np.

To post a reply please login or register

Same-day dentistry: Replacement of two PFM crowns with zirconia restorations

The advancements in zirconia in contemporary dentistry allow for a wider range of applications, including in the anterior region, and for chairside ...

3s PowerCure: The art of efficiency with posterior restorations

COLOGNE, Germany: The incremental layering technique is very time-consuming, especially when dealing with large cavities. Dentists can now reduce their ...

3D-printed provisional restorations for complex prosthetic rehabilitation: Full-mouth restoration of a severe case of erosion

Dental erosion caused by direct acid exposure without bacterial involvement has become increasingly clinically relevant in recent years.1 The extent of ...

How to polish a composite restoration in the posterior area

Every dentist aims to polish to a high gloss without damaging the freshly modelled occlusal surface. To achieve this, it is essential to use high-quality ...

Aesthetic restoration of posterior teeth with composite resins and ceramic inlays

The restorative dental treatment possibilities available to practicing dentists have grown immensely over the past few decades. Considerable progress has ...

Four questions on current trends in direct posterior and anterior restorations

Dr Alexandra Papanikolaou owns a private dental clinic in Athens in Greece, focused mainly on restorative and aesthetic dentistry. In an upcoming webinar, ...

Complex direct ORMOCER composite restorations in the posterior region

For reasons of cost, patients and dentists today often find themselves obliged to use restorative materials for the treatment of large structural, ...

A new era of chairside restorations: “Midas is the first of its kind”

At this year’s International Dental Show (IDS), SprintRay is showcasing its latest development, Midas—a groundbreaking product revolutionising chairside...

Individualisation of monolithic zirconia restorations

HILDEN, Germany: By providing a natural colour gradient and high translucency, the modern multilayered zirconia KATANA Zirconia STML (Kuraray Noritake ...

BEST.FIT: A hybrid technique for efficient and aesthetic restoration of anterior teeth

The introduction of new-generation composites, with high nano-filler loading, has opened doors to new techniques for managing direct and semi-direct ...

Education

Live webinar
Tue. 16 September 2025
11:00 am EST (New York)