Additive Direct Composite Restorations (ADCR) in the Anterior Area
This program is designed for dentists wishing to achieve excellence with direct anterior composite restorations.
The final aesthetic outcome of an anterior restorations depends on the combination of the final form of the restoration with the color selection, tooth anatomy and the thickness of each composite shade.
Clinicians should have a precise idea of the form of the final restoration in their mind before starting color selection and composite layering (Deliperi, 2011).
Three mandatory steps are recommended when placing direct anterior composite restorations:
1-pre-op mock and/or wax-up to determine the final form of the restoration
2-shade selection and optical characteristic reproduction based on tooth age
3-evaluation of tooth thickness to manage the three-dimensional layering of dentin and enamel shades
Current evidence-based research supporting this technique will be presented.
The course will cover an additive approach for the restoration of both vital and devital teeth in the anterior area. Tooth whitening procedures will be presented as a mean to preserve as much tooth structure as possible (Deliperi, 2008); a step-by-step protocol will guide clinicians to “go additive” in most direct anterior applications! Participants will learn how to mimic both the mamelon expression, the incisal characterization and the incisal halo.
Particular attention will be given to the non invasive restoration of discolored and structurally compromised teeth as well as teeth resistant to bleaching procedure. A fiber lay down protocol will be presented to increase the fracture toughness of these teeth.
Attendees will also learn how to integrate direct composite and indirect porcelain restorations in a patient smile.
Completion of the course should provide attendees with many tips and tricks they may apply the next Monday in their practice.
Topics covered through demonstration and hands-on experience:
- Silicone Matrix Fabrication
- Criteria for composite choice: single mass vs dual vs polychromatic technique
– Shade selection for the cervical, middle and incisal third
- Composite layering protocols for Class IV, diastema closure, composite veneers and the biomimetic SRDC crown
- Additive composite layering procedure for both vital and devital teeth
- Finishing and polishing: how to reproduce the macro and micro-texture of the natural teeth
- Fiber lay down protocols for structurally compromised teeth
- Understand plus and minus of different composite systems
- Learning specific layering protocols for different composite brand to restore vital and devital anterior teeth
- Compare a direct technique with traditional techniques available for the restoration of anterior teeth (porcelain laminate veneers, zirconia crowns)
- Understand how to replicate the esthetic appearance of porcelain restorations with a step-by step protocol for direct restorations
- Become familiar with a new technique for the restoration of discolored teeth resistant to bleaching
- Learn a fiber lay down protocol to mimic the functional characteristics of the natural dentition when teeth are structurally compromised
Day I, II : Class IV restorations and Additive Direct Composite Veneers
Guidelines to mimic the optical characteristics of the young, adult and mature dentition in the cervical, middle and incisal third of the tooth
The 3D meticulous management of the body, dentin, trans and enamel shades to achieve both color integration and vitality (color depth) of the restoration in the incisal third
Class IV, diastema closure, composite veneers
How to avoid aesthetic failures
Day III, IV: Fiber lay down protocols for structurally compromised teeth
Stress-reduced direct composite restorations (SRDC) for structurally compromised teeth
How to preserve ultra thin remaining cavity walls via fiber lay down protocols
Combined endodontic access and class IV-Class III restorations
How to mask the tooth discoloration through a prepless approach: contraindication for tooth preparation in shade matching
Day V: Advanced protocols for ADCR
The perio-restorative approach to class V lesions and gingival recession: a combined restorative and surgical approach
Treatment of localized dental erosion in the anterior area via ADCR
The Full mouth rehabilitation via SRDC and ADCR protocols
ADCR vs Porcelain Veneers and the combined ADCR-Porcelain veneer restoration approach