Advances in the mechanical properties of composite resins have allowed for their use in posterior teeth. Conventional resins have several problems associated with polymerization shrinkage stress. The development of “bulk-fill” resins has allowed for their use in single increments up to depths of 4 mm, with very low polymerization shrinkage stress. Nevertheless, differences in anatomy and the desire for optimal esthetics present unique difficulties. This article describes a step-by-step technique using flowable bulk-fill resin as a substitute for dentin in a single increment, together with a high-reflective-index resin to restore enamel and decrease clinical time, obtaining anatomically and esthetically acceptable results without detriment to the mechanical properties required to restore the functionality of the posterior teeth.
The maxillary midline diastema is a common esthetic problem in patients. Assess and diagnose may be challenging due to the many factors that influences the alteration of tooth eruption process and tooth shape. Due to the various advantages and the reversibility of treatments, composite resins are today a suitable aesthetic and functional option, even so, its management and technique require a trained and experienced clinician in order to obtain an optimal outcome. The following report, is a clinical case of a 21-year old female with a main complaint of a maxillary midline diastema produced by the alteration in tooth shape and size of both upper central incisors, which was closed and corrected with direct composite resins.
The use of CAD/CAM technology has allowed the fabrication of ceramic restorations efficiently and with predictable results. Lithium disilicate is a type of glass ceramic material that can be used for the elaboration of laminate veneers, being monolithic restorations which require characterization through a covering ceramic in order to achieve acceptable esthetic results. The next case report shows a predictable clinical protocol for the rehabilitation of the anterior teeth through the preparation of CAD/CAM veneers (e.max CAD, Ivoclar Vivadent, Liechtenstein) which have been characterized by a nanofluorapatite ceramic (e.max Ceram, Ivoclar Vivadent, Liechtenstein) through the layering technique.
Statement of the problem:The literature still lacks evidence regarding which polishing techniques have the ideal clinical outcomes for bulk-fill resin composites. Purpose: This study evaluated the surface gloss of two commercially available bulk-fill resin composites after different polishing procedures and characterized their micromorphology via scanning electron microscopy. Material and Methods: 80 bulk-fill compactable composite resin discs were created. The control group was left untreated, and remaining samples were subjected to different polishing techniques. Gloss units were measured and surface morphology of disc samples was assessed. The Tukey post-hoc test was used to identify any differences. Results: Statistically significant differences were found between the different polishing systems applied to Filtek BulkFill Posterior and Tetric N Bulk-Fill. No differences were found when the same polishing system was applied for both resins. The highest gloss values were obtained in the control group and the ENA Shiny system; the lowest were obtained with SofLex XT and Soflex Spiral Wheels for the bulk-fill composite resins studied. Conclusions. Diamond pastes have the highest gloss behavior, followed by diamond rubber points. The systems with aluminum oxide discs present the lower gloss behavior. SEM images provided useful evidence, and future studies should include an evaluation over time.
The use of Bulk-Fill composite resins to perform posterior restorations has been massified in recent years in the different clinical disciplines of Dentistry. This may be due mainly to the simplicity in the application technique of this material as it requires its insertion into the cavity preparation in 4-5mm of composite resin thickness, achieving a considerable reduction of clinical working time. Given the existence of different viscosities of this type of composite resins, certain difficulties have been identified before the selection of each Bulk-Fill material related to the possible combinations that can be made between the different brands available in the market, even when they are used with conventional composite resins. The purpose of the following case report, is to present two step-by-step clinical possibilities using initially, compactable Bulk-Fill composite resin in a single increment for the restoration of a second upper molar, and later, through the combination of Bulk-Fill flowable composite resin together with compactable Bulk-Fill composite resin and a high-refractive-index enamel-like conventional composite resin, for a first upper molar.
La empatía es un elemento clave tanto para la relación médico-paciente como para el éxito de un tratamiento médico, y se hace necesario prestarle atención a esta dimensión en nuestra enseñanza odontológica, muchas veces inadvertida a causa de nuestra "cultura del rendimiento".
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