#28 DO- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

From yesterday #28 DO decay below the CEJ on 95 yo male. He was a soldier in France during WW2 and when the war ended his job was to shoot off all the left over Howitzer ammo, so has absolutely zero hearing. At his age we're trying to keep up with his decay rate, which is high regardless of what we do.

Thomas W. Mitchell, DDS, FAGD
Decay at 28 CEJ.
Thomas W. Mitchell, DDS, FAGD
From the occlusal we can see the color change on the distal marginal ridge.
Thomas W. Mitchell, DDS, FAGD
From the buccal the decay is right at tissue level behind the Class 5 composite.
Thomas W. Mitchell, DDS, FAGD
Here's the basic prep
Thomas W. Mitchell, DDS, FAGD
Triodent matrix applied without a wedge. Then Clean and Boost for 15 seconds to clean it and help with the enamel etch. Washed and lightly dried.
Thomas W. Mitchell, DDS, FAGD
Superb applied and left alone for 20 secs, then 2 more brush fulls applied and lightly blown off.
Thomas W. Mitchell, DDS, FAGD
Then a thin layer of Titan Flowable shade A2 applied over the Superb.
Thomas W. Mitchell, DDS, FAGD
And the Superb and Titan co-cured. With out the wedge I forced the matrix tight against #30 so I could be sure of getting a contact.
Thomas W. Mitchell, DDS, FAGD
Then filled the matrix almost to the top with Injectafil
Thomas W. Mitchell, DDS, FAGD
I let the Injectafil reach it's gel stage, then added a couple of seconds of Valo light on the regular setting.
Thomas W. Mitchell, DDS, FAGD
Then a top coat of Exquisite.
Thomas W. Mitchell, DDS, FAGD
Gently shaped the Exquisite and cured for 5 seconds
Thomas W. Mitchell, DDS, FAGD
Matrix removed and ready to polish. I only used Thin Red Softflex discs.
Thomas W. Mitchell, DDS, FAGD
Ready to remove the dam.
Thomas W. Mitchell, DDS, FAGD
And after the final polish.
Thomas W. Mitchell, DDS, FAGD
Occlusion adjusted and glazed with a thin coat of Superb. Valo light for 20 secs for final cure.

Case by: 

Thomas W. Mitchell, DDS, FAGD