#19 Adding to Existing Comp. and Repairing a White Line- ByThomas W. Mitchell, DDS, FAGD

Introduction: 

This is #19 with a 2012 occlusal composite + new mesial decay. My plan was to do a new MO composite, but the existing composite was fine so I decided to just add the mesial surface. Originally this was done with Surpass and Heliomolar so I used the same materials. Recent research has shown that this is a viable procedure, as we only get 70-80% conversion from single bonds to double bonds, so there's always some uncured molecules available. I did struggle a bit getting the composite layered well, and used too much light too soon, creating a white line, which I repaired with Interface and Surpass.

Thomas W. Mitchell, DDS, FAGD
Originally 19 was restored with Surpass by Apex Dental Materials and Heliomolar by Ivoclar. Heliomolar is a microfill with a wear rate similar to the nanofills. Unlike Exquisite it can shrink too fast with too much light, damaging the enamel margins and creating white lines at the margins.
Thomas W. Mitchell, DDS, FAGD
The existing occlusal filling is fine and really doesn't need to be replaced.
Thomas W. Mitchell, DDS, FAGD
This is after prepping and placing a Triodent Matrix. Then we cleaned the prep with Clean and Boost, etched with Surpass 1 for 10 secs, added 3 brush fulls of Surpass 2 and dried aggressively, then co-cured a thin layer of Surpass 3 + Titan Flowable for 10 seconds.
Thomas W. Mitchell, DDS, FAGD
I needed 2 layers to fill the matrix, and even though I was pulse curing for 3 secs only for each layer, that was obviously too much light as evidenced by the white line on the mesial margin.
Thomas W. Mitchell, DDS, FAGD
Then we mixed Interface, which is Apex Dental Materials "super silane", let it dwell on the margin for 10 secs, dried it and added Surpass 2, dried that and added Surpass 3. I air-thinned the Surpass 3 and light cured for 10 secs. The white line disappeared.
Thomas W. Mitchell, DDS, FAGD
The contact is fine and the final film looks good. I think the mesial occlusal embrasure is a bit closed. I've started to cut off the tab on the top of the Triodent matrix so I can shape the matrix better.

Conclusion: 

This shows a couple of procedures recommended by Dr. John Kanca that are very effective. We can easily use these to achieve great results and make our days easier.

Case by: 

Thomas W. Mitchell, DDS, FAGD