USERREPORT

by DR. ARUN RAJPARA

Ivoclar Vivadent

Creating ultimate direct anterior restorations with nano technology composite

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Fig 1: Initial situation of carious lesions on maxillary and mandibular anterior teeth showing inammation on surrounding gingival tissue with compromising smile esthetics.

reating consistent results with esthetic dentistry is certainly the ultimate goal that every clinician wants to achieve. However achieving this result and patients satisfaction can be elusive at times! Because esthetic restorative dentistry is artistic in nature, so there is much subjectivity in fabricating the final esthetic result. Creating beautiful direct resin restorations requires the clinician to perform on a multi-dimensional platform. Clinicians has to consider from gingival architecture to tooth contour, from colour to surface texture and all the different aspects present in the patients smile zone so as to arrive at the ideal result. On a conceptual level, having an understanding of the final result is one thing; choosing the ideal case and executing the process is another. In all circumstances, the

direct resin application technique is so versatile that clinicians can add, reduce, polish and re-polish the composite veneering material until the desired outcome is achieved. Clinicians have seen the revolution in composite material science and technique since the advent of the acid etch technique in 1955. The development of hydrophilic dentin bonding agents have further added a new horizon to restorative possibilities. There is a significant advantage of the modern direct adhesive composite systems - they allow clinicians to preserve sound tooth structure during the removal of caries and preparations as compared to traditional restorative procedures. The new composite restorative Tetric N-Ceram (Ivoclar Vivadent) also comprises features of nanotechnology. Nano additives have been incorporated and helps the material to sustain a good viscosity and good polishability. Further organic pigments, covalently bonded to silicon dioxide particles in a nanoscale range, enable an outstanding colour match with a natural tooth structure, there by outstanding aesthetic results clinically. To complement this composite resin there is Tetric N-Flow with nano-optimized technology. This helps clinicians achieve a predictable aesthetic result clinically. Nano filled, light cured, single-component total-etch adhesive Tetric N-Bond ideally complements the Tetric N-Family products. The objective of this article is to introduce the clinical application of this new Tetric N-Ceram/Flow/Bond in clinical cases. The rationale behind the clinical technique and intricate application methods is discussed.

Clinical case
Fig 2: A close-up view of maxillary incisors showing a need for esthetic restorations.

A young patient, a 16-year-boy, who had large cervical and proximal carious lesions on all maxillary and mandibular anterior teeth was presented. (Fig. 1 and Fig. 2) All these lesions were surrounded with white hypo calcified enamel lesions. The patient had a history of restorations on these in the past which proved to be a failure overtime. Clinically it was also observed that there was a chronic gingival inflammation, hyperplastic gingiva with bleeding from marginal areas.

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Dental Asia July / August 2009