Technique in 2 Minutes: How to Increase Efficiency, Predictability, And Durability In Class I Restorations

October 23, 2020
Dr. Robert Ritter

A brief visual technique guide to a Class I case restored using Ivoclar Vivadent's Adhese Universal, Tetric PowerFill, Tetric PowerFlow, and Bluephase PowerCure.

Video Transcript:

How to Increase Efficiency, Predictability, And Durability In Class I Restorations

An 18-year-old female patient presented to the dental practice for a routine hygiene appointment and checkup. During a thorough clinical exam, probing detected “stickiness” on the occlusal surface of tooth No. 18, which was verified as isolated Class I occlusal caries.

The agreed-upon treatment plan involved removing the caries using a conservative and minimally invasive approach to maintain the integrity of the tooth structure and retain as much enamel as possible for a durable, long-lasting restoration.

The tooth would be restored using a tooth-colored composite material. The patient was anesthetized, and the site was isolated using a rubber dam.

A carbide bur was used to remove the carious lesion followed by a diamond bur to smooth and refine the angles of the preparation.

With the preparation design complete, the phosphoric acid, Total Etch from Ivoclar Vivadent, was applied to the enamel for 15 seconds and dried using the Warm Air Tooth Dryer from A-dec.

After the preparation was thoroughly rinsed, Adhese Universal was applied, using the Adhese Universal VivaPen single unit dose applicator.

The adhesive is then air dried using a warm air dryer.

Next the adhesive was light cured for 3 seconds using the Bluephase PowerCure, a highintensity LED curing light from Ivoclar Vivadent.

Now, the first layer of flowable direct composite—Tetric PowerFlow from Ivoclar Vivadent—in shade IVA was placed as a dentin replacement

It is then cured for 3 seconds using the Bluephase PowerCure. This flowable composite is used to coat the internal aspects of the cavity and to ensure a complete seal against microleakage and recurrent caries.

During polymerization, the initial visual high translucency gradually changes to a more opaque shade that is close to that of natural dentin in value. The material’s final opacity conceals the stained underlying tooth structure to optimize the esthetics of the final restoration.

After the flow layer is placed and cured, a layer of Tetric PowerFill bulk fill composite from Ivoclar Vivadent in shade IVW was placed in a single 4-mm increment. It is sculpted using a contouring instrument and light cured for the manufacturer-recommended 3 seconds.

Once curing and occlusal adjustments were made, the restoration was finished and polished using a silicone polisher to create the final occlusal restoration seen here.