31 Occlusal Technique as fast as I want to go- By Thomas W. Mitchell, DDS, FAGD

Introduction: 

This is replacing a worn out occlusal composite on 31 done as fast as I want to go. I could have gone faster if I'd bulk filled, but I'm OCD about anatomy and bulk filling doesn't make that easy, or even possible, for me. Here I'm using Clean and Boost, Superb, WO Titan Flowable, Seamfree, and Exquisite.

Thomas W. Mitchell, DDS, FAGD
A worn out old occlusal composite poorly bonded so the enamel bond just fell apart and the filling popped out in chunks.
Thomas W. Mitchell, DDS, FAGD
Simple straight forward prepping just being sure I got all the old stuff out and have all my margins on enamel.
Thomas W. Mitchell, DDS, FAGD
Since I'm using Superb, a one bottle system and as you know all one bottle systems don't etch enamel very well, I leave the Clean and Boost on for at least 20 seconds to be sure the enamel is well etched. Then I wash it off and lightly dry the area and add one brushfull of Superb. Leave that one for 20 seconds and quickly add 2 more brushfulls. Air thin that and add a layer of Titan Flowable. Here I'm using WO because this has been a big cosmetic case and I want the filling to be bright. Then co-cure the Titan and Superb with my Valo light set on XTRA POWER, the "plasma mode" setting, for 3 seconds.
Thomas W. Mitchell, DDS, FAGD
Then I layer Exquisite in the lingual half, forcing it against the lingual prep walls with pressure from the side of a condensor, and shaping it with a flat bladed instrument and an acorn carver with Seamfree. Then cure it for 3 seconds with the Valo light on XTRA POWER.
Thomas W. Mitchell, DDS, FAGD
Then add in the buccal half, shape it and blast it with the Valo light. You can see I was a little sub marginal at the ML corner.
Thomas W. Mitchell, DDS, FAGD
So I added a little more Exquisite and cured it again.
Thomas W. Mitchell, DDS, FAGD
Took the dam off, checked the occlusion and adjusted the high spots. I was using the Brasseler diamond kit that Dr. John Kanca designed.
Thomas W. Mitchell, DDS, FAGD
The last step is to pumice off all the junk from the marking paper and the adjusting, then place one more coat of Superb, thin that and blast again with the Valo light.

Conclusion: 

That's as fast as I can go and still get the quality restoration that I want. You can go faster with bulk filling (and I do that with smaller restorations) but with areas this large I spend much more time shaping the anatomy. This was not any longer than 20 minutes of my time even with all the photos.

Case by: 

Thomas W. Mitchell, DDS, FAGD