Paramount in a busy clinical setting is the use of techniques and materials resulting in long-lasting restorations that promote oral health and are aesthetically pleasing. A versatile class of materials, featuring bioactive Giomer technology, meet all of these parameters with the bonuses of fluoride release and recharge and excellent handling.
Beautifil II LS (Shofu Dental) is a packable Giomer composite with a unique filler content that delivers optimal surface hardness, compressive strength, wear, and aesthetics, making it a great choice for both posterior and anterior restorations. With the volumetric shrinkage under 1% and minimal polymerization shrinkage, margins result in exceptional longevity and strength.
In the presented clinical case, the patient had a history of widespread decay due to a questionable diet and home care program. Additionally, the patient mentioned disliking the white-spot lesions that were evident on the enamel. After options were discussed, a mutual decision was made to restore and enhance the tooth surface appearance with an aesthetic bioactive composite. The anti-plaque effect and regenerative properties of Giomer materials help ensure long-lasting restorations, preventing further deterioration of the tooth structure without compromising the aesthetics (Figure 1).
|Figure 1. Widespread anterior decay with decalcified enamel.||Figure 2. Conservative preparations with a 330 carbide bur.|
|Figure 3. Enamel margins and decalcified areas with irregular, uneven bevels.||Figure 4. After etch and bonding, Giomer flowable was placed and cured over all dentin surfaces.|
|Figure 5. The Giomer packable material has great handling, great viscosity, and a great ability to be sculpted.||Figure 6. The result is excellent cosmetics with the proven durability of Giomer restoratives.|
Preparations were done with a 330 carbide bur in a high-speed handpiece, followed by decay removal with a slow-speed #2 round bur, which was verified by a caries indicator (Figure 2). The surface of the tooth was beveled using a thin finishing diamond in an irregular, uneven method to create an imperceptible transition between the tooth structure and the restorative material. The enamel decalcification was prepped with varying thicknesses to improve the light deflection to develop an aesthetic and natural-looking appearance (Figure 3).
Teeth were isolated with retractors, and celluloid matrices were placed. Total etching was done with 37% phosphoric acid for 15 seconds, followed by rinsing, suction “drying,” and placing of a thinning universal bonding agent. Following the application, a 1-mm layer of Giomer flowable composite (Beautifil Flow Plus X) was placed, covering the entire dentin, and light cured (Figure 4). The thorough polymerization of this layer is critical in asymptomatic restorations.
The remainder of the cavity preparations and the facial surfaces were filled with Beautifil II LS (Figure 5). The excellent sculptability and non-sticky handling make it a great choice for anterior cosmetics while also providing the durability of a posterior composite. The decalcified white areas were masked well with minimal preparation and effort. Shaping was completed with a finishing diamond and was easy to achieve; long-lasting polish was effortlessly accomplished with Super-Snap X-Treme polishing disks (Shofu Dental) (Figure 6).
The result showed durable aesthetics with a material that promotes a healthier oral environment.
For more information, call Shofu Dental at (800) 827-4638 or visit shofu.com.
Dr. Griffin is in private practice in Missouri (mysmilecenter.com). He has Diplomate status with the American Board of Aesthetic Dentistry, accreditation with the American Academy of Cosmetic Dentistry, and a Mastership in the AGD.