The "Index Cutback Technique" A Three-Dimensional Guided Layering Approach in Direct Class IV Composite Restorations - Riccardo Ammannato

CLINICAL RESEARCH
The “index cutback technique”:

a three-dimensional guided layering
approach in direct class IV composite
restorations
Riccardo Ammannato, DDS
Private Practice, Genova, Italy
Federico Ferraris, DDS

Private Practice, Alessandria, Italy
Mario Allegri, DDS

Private Practice, Verona, Italy
Correspondence to: Dr Riccardo Ammannato

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THE INTERNATIONAL JOURNAL OF ESTHETIC DENTISTRY
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*OUSPEVDUJPO concentrate on selecting the right colors

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NPSFBOBUPNJDBMBTQFDUT this article is a modified and improved
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PGUIFOBUVSBMUPPUI"TQPJOUFEPVUQSFWJ- strategy with respect to the conventional
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However, these layering strategies are
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453
70-6.&t/6.#&3tWINTER 2017
CLINICAL RESEARCH
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ing a class IV direct composite restor-
ation is the management of composite
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the enamel is placed to create palatal,
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enamel composite masses when the
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ported enamel and the removal of dis- is employed), important static and dy-
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454
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these reasons that the freehand layering
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different ways:
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ed it has a good shape and the clin-

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managed with wooden wedges and
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emergence profile and a good contact Fig 6 *ODJTBM WJFX PG UIF DVUCBDL XBYVQ 5IF
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enamel in the incisal third, together with UVSFSFTUPSBUJPO
opalescence and stains, then have to
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protocol
trices that allow the clinician to control
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composite layers in a more predict- DMJOJDJBOXJUIBHVJEFEDPQZBOEQBTUF
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455
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CLINICAL RESEARCH
Fig 8 *O UIF NJEEMF UIJSE UIF BNPVOU PG XBY SF-
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456
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Fig 10 5IFDVUCBDLEFOUJOJOEFYJTDBSSJFEPVUPO Fig 11 5IFGVMMFOBNFMJOEFYJTDVUXJUIBCMBEFUP

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cal walls of the composite enamel res- "O BEIFTJWF UFDIOJRVF QSPUPDPM GPM-
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ter the selection of dentinal/enamel com- MFDUFE XIJDIDBOBMTPCFQSFIFBUFEJO
posite masses, the field is isolated and order to have a higher conversion in the
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457
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Fig 14 'JOBMSFTVMUBGUFSZFBST Fig 15 'JOBMSFTVMUBGUFSZFBST
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PVTMZTFUMBOENBSLT"TNBMMDIVUFDBO UIFTF LJOET PG TJUVBUJPOT XIFSF UIF $
CFNBEFXJUIBCVSPOUIFUSBOTQBSFOU GBDUPSJTPOFPGUIFNPTUGBWPSBCMFEVF
JOEFYUPBMMPXUIFGMPXPGUIFFYDFTTDPN- to the cavity design, is not considered
a b c
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458
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a b c
Fig 17 (a)8BYVQBGUFSUIFDVUCBDLPGUIFFOBNFMMBZFS UIFUIJDLOFTTPGXIJDIJTBSPVOENNJOUIF

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a b
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459
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a b c
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TUSFTTGVMGPSUIFSFTJEVBMIFBMUIZIBSEUJT-
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Afterwards, the palatal wall is restored
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each with a sectional transparent ma-
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The last layering step is performed UIJTTUFQ BTNBMMDIVUFDBOCFNBEFXJUI
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Fig 23 'VMM FOBNFM JOEFY QPT- Fig 24 'JOBMSFTVMUBGUFSGJOJTIJOHBOEQPM-

itioned on the central incisor for the JTIJOH5IFEJGGVTFEMJHIUPGUIFQIPUPHSBQI
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461
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Fig 26 *OJUJBMSBEJPHSBQI
Fig 25 *OJUJBM DMJOJDBM TJUVBUJPO 5IF QBUJFOU DPN-

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composite system chosen for the restorations and
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Fig 29 The cavity prepared for the restorative se- Fig 30 5XPHMBTTGJCFSQPTUTBSFDFNFOUFEJOUIF
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Fig 33 The restorations of teeth 11 and 21 after

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463
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CLINICAL RESEARCH
Fig 35 'JOBMSBEJPHSBQI
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The "Index Cutback Technique" A Three-Dimensional Guided Layering Approach in Direct Class IV Composite Restorations - Riccardo Ammannato

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The "Index Cutback Technique" A Three-Dimensional Guided Layering Approach in Direct Class IV Composite Restorations - Riccardo Ammannato

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CLINICAL RESEARCH

The “index cutback technique”:

Federico Ferraris, DDS

Mario Allegri, DDS

Correspondence to: Dr Riccardo Ammannato

*OUSPEVDUJPO concentrate on selecting the right colors

Fig 1 *OJUJBMDBTFZPVOHQBUJFOUXJUIBGSBDUVSFPG Fig 2 After field isolation, minimal chamfer prep-

ed it has a good shape and the clin-

5IF JOUFSQSPYJNBM TVSGBDFT BSF VTVBMMZ

"GUFSUIFDBTUTIBWFCFFOHFOFSBUFE GBDFT 'JHTBOE 95IFBQQSPYJNBUF

Fig 10 5IFDVUCBDLEFOUJOJOEFYJTDBSSJFEPVUPO Fig 11 5IFGVMMFOBNFMJOEFYJTDVUXJUIBCMBEFUP

Fig 12 5IFGVMMFOBNFMJOEFYJTDVUXJUIBCMBEFUP Fig 13 'JOBMSFTVMUBGUFSXFFL

Fig 14 'JOBMSFTVMUBGUFSZFBST Fig 15 'JOBMSFTVMUBGUFSZFBST

JOEFY BOEUIFOQSFTTFEPOUPUIFUPPUI QPTJUFEVSJOHUIFNPMEJOHQSPDFTT-JHIU

Fig 16 (a)'SBDUVSFPGUPPUIJOBOZFBSPMEQBUJFOU(b).JOJNBMDIBNGFSQSFQBSBUJPO BQQSPYJNBUFMZ

Fig 17 (a)8BYVQBGUFSUIFDVUCBDLPGUIFFOBNFMMBZFS UIFUIJDLOFTTPGXIJDIJTBSPVOENNJOUIF

Fig 19 (a)-JHIUDVSJOHPGUIFEFOUJOBMCPEZUISPVHIUIFUSBOTQBSFOUDVUCBDLEFOUJOJOEFY(b) Composite

Fig 20 5IFQBMBUBMTIFMMDPNQPTJUFFOBNFMDVSFE Fig 21 "EEJUJPOBM TUBJOT BOE USBOTMVDFOU FGGFDUT

Fig 23 'VMM FOBNFM JOEFY QPT- Fig 24 'JOBMSFTVMUBGUFSGJOJTIJOHBOEQPM-

Fig 25 *OJUJBM DMJOJDBM TJUVBUJPO 5IF QBUJFOU DPN-

NPMEJOHQSPDFTT5IFGVMMCVDDBMJOEFY UPNZ " TJMJDPOF QPJOU PO B IBOEQJFDF

When the indications are present, the

Fig 33 The restorations of teeth 11 and 21 after

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Fig 1 *OJUJBMDBTFZPVOHQBUJFOUXJUIBGSBDUVSFPG Fig 2 After field isolation, minimal chamfer prep-

"GUFSUIFDBTUTIBWFCFFOHFOFSBUFE GBDFT 'JHTBOE 95IFBQQSPYJNBUF

Fig 12 5IFGVMMFOBNFMJOEFYJTDVUXJUIBCMBEFUP Fig 13 'JOBMSFTVMUBGUFSXFFL

Fig 14 'JOBMSFTVMUBGUFSZFBST Fig 15 'JOBMSFTVMUBGUFSZFBST

JOEFY BOEUIFOQSFTTFEPOUPUIFUPPUI QPTJUFEVSJOHUIFNPMEJOHQSPDFTT-JHIU

Fig 16 (a)'SBDUVSFPGUPPUIJOBOZFBSPMEQBUJFOU(b).JOJNBMDIBNGFSQSFQBSBUJPO BQQSPYJNBUFMZ

Fig 17 (a)8BYVQBGUFSUIFDVUCBDLPGUIFFOBNFMMBZFS UIFUIJDLOFTTPGXIJDIJTBSPVOENNJOUIF

Fig 19 (a)-JHIUDVSJOHPGUIFEFOUJOBMCPEZUISPVHIUIFUSBOTQBSFOUDVUCBDLEFOUJOJOEFY(b) Composite

Fig 25 *OJUJBM DMJOJDBM TJUVBUJPO 5IF QBUJFOU DPN-

NPMEJOHQSPDFTT5IFGVMMCVDDBMJOEFY UPNZ " TJMJDPOF QPJOU PO B IBOEQJFDF

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