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RESTORATIVE & ADHESIVE

10 TIPS on Posterior direct

restoration in daily flow
a 5 February 2018  by Giuseppe Marchetti  Views 54,110

Few rules and 10 TIPS for posterior and anterior direct restorations must
be followed, as these restorations are a very big part of our everyday
routine, here are some knowledge and tricks for reaching the correct
result and keep it in time. Let’s take a look at them.

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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

Fig.1
Preoperative picture of the
quadrant to treat, after the
anesthesia

Fig.2
First rule: a correct
isolation with the rubber
dam starts before the
cleaning of the caries. You
reach a better adhesion
without saliva
contamination.
TIP #1: use the wooden
wedges to protect the
rubber dam while cleaning
the caries otherwise you
will probably break it using
the burs on the cervical
step, and you will need to
change it before the
bonding procedures

Fig.3
Second rule: prepare the
cavities, cleaning all the
caries and re ning the
enamel with ne grained
diamond or multiblade
burs, so to have a perfect

bonding to the enamel and
avoid the detachment of
unsupported enamel and

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micro-leakage.
TIP #2: it could happen
that, after removing the
wedges, a little bleeding
occurs as in distal 24
mesial 25. Pay attention to
wash properly to disinfect
and to control the wetness
before putting in place the
matrix and the new
wedges
TIP #3: clean the dentin
with glycine and disinfect it
with clorexidine at 2%

Fig.4
TIP#4: there’s no
preference in putting one
matrix by one or all
together. It depends on
what you prefer and are
able to do and nobody can
say that one way is better
than the other. The
advantage in putting them
all together is that you
save time, you don’t
contaminate the neighbor
cavities and don’t have the
need to re ne the
restorations one by one
before putting in place the
other matrix. The
disadvantage is that you

have less control and need
a little more experience in
doing this.

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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

TIP#5: use a selective

etching procedure and a
universal (8th generation)
adhesive in a self etching
mode, for the bonding
procedures.

Fig.5
Third rule: start building
the interproximal wall rst
so to change the class II in
a class I
TIP#6: before removing the
matrix apply a little of ow
between the dentine and
the interproximal wall
you’ve done previously,
otherwise you risk to
remove the wall while
pulling the matrix.

Fig.6
Fourth rule: do not remove
the wedges until the end
of the layering and
modeling work, so to avoid
the risk of bleeding from
below
TIP#7: use a ow on the
adhesive to have a better
conversion of the adhesive
itself and to counteract
the C Factor, before start
layering the packable 
composite

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Fig.7
Fifth rule: there’s no best
one among layering
techniques. You can
choose a horizontal, a
vertical or an oblique one.
The horizontal one is easier
to perform, but keep in
mind that what you have
to reach is a good result,
nothing else, and you can
get it with each and every
layering technique.

Fig.8
Details after the modeling,
before the nishing and
polishing procedures.
TIP#8: use an easy
modeling technique, no
need of reproducing
something that in nature
doesn’t exist. The essential
is more than enough.

Fig.9
Details after nishing and
polishing.
TIP #9: use a multiblade
bur on composite instead
of a diamond one for
nishing, it’ll be gentler
and it won’t damage the
enamel while you are 
nishing your restorations

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Fig.10
Details after polishing
procedures
TIP #10: use a
supercharged diamond
paste to polish your
restorations, only one is
su cient. Use it with a
brush or with the spirals

Fig.11
Occlusal check: it requires
some corrections, that are
immediately carried out.

Fig.12
Details of the anatomies
after the removal of the
rubber dam

Fig.13
Details of the anatomies
after the removal of the
rubber dam.

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Fig.14
Occlusal check at six
months.

Fig.15
Details of the anatomy and
of the morphological and
chromatic integration at six
months check.

Fig.16 Details of the anatomies and of the morphological and

chromatic integration at six months check. 

CONCLUSIONS
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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

In modern restorative dentistry it is quite easy to work clean and to 18 Comments

perform with good results, even if you are not a “pro”. Use the rubber dam
from the start, clean all the decayed tissue, leaving any on the bottom of
the cavity, properly finish the enamel, clean and disinfect the dentin, use Add a co
a modern adhesive in a self etch way. No flights of fancy, no time to lose,
no 1000 layers of composite, but a few steps and rules to follow, and… Ziliya Chayk
have fun working! thank you fo
Like · Reply · 3

BIBLIOGRAPHY Shravan Ra
Can you tell
Dietschi D, Spreafico R. Restauri adesivi non metallici. Attuali concetti per multiblade w

il trattamento dei denti posteriori. Scienza e Tecnica Dentistica Passirana Like · Reply ·

di Rho, 1997; br., pp. 215. Gius

Bichacho N. The centripetal build-up for composite resin posterior I use
Like
restorations. Pract Periodontics Aesthet Dent. 1994 Apr
Magne P. IDS: Immediate Dentin Sealing (IDS) for tooth preparations.  J Giuliano Be
Adhes Dent. 2014 Dec;16(6):594. doi: 10.3290/j.jad.a33324. Great tips! C
Manauta J, Salat A. Layers: An Atlas of Composite Resin Stratification; sharing to us
Like · Reply ·
Quintessence. Print; 2012.
Gius
Than
Like

Raghed Mu
thank you 😊
Like · Reply ·

Shaima Nab
Thank you
Like · Reply ·

Bahaa Beha
Thanx for sh
Kindly expla
#7
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
Monika Tys
Thanks for s
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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

Raja Brini
thank you
Like · Reply ·

Oscar Mura
Thanks for th
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Gius
Than
Like

Dr-refat Ham
Thank You

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Tags: 3M COMPOSITE DIRECT POSTERIORS ISOLATION

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ABOUT AUTHOR
GIUSEPPE MARCHETTI

CASES AND PRODUCTS



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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

Easy ll up in posterior composite restorations

1 October 2016

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23/4/2020 10 TIPS on Posterior direct restoration in daily flow - styleitaliano.org

How to use a sectorial matrix in order to achieve a functional proximal

surface

14 December 2016

Essential Lines

15 January 2018

3M

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