The document provides detailed information on direct composite restorations, including indications, contraindications, advantages, and disadvantages of various types, such as conventional, microfilled, hybrid, flowable, and packable composites. It outlines clinical techniques for class III, IV, and V restorations, detailing tooth preparation methods and entry approaches. Key features of nanocomposites and their enhanced properties due to nanoparticulates are also discussed.

1. CLASS III, IV and V
DIRECT COMPOSITE
RESTORATIONS
Upload By : Ahmed Ali Abbas
Babylon University College of Dentistry
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3. Indications:

4. Indications:
 restorations in esthetic prominent
areas

5. Indications:
 restorations in esthetic prominent
areas
 areas can be adequately isolated

6. Indications:
 restorations in esthetic prominent
areas
 areas can be adequately isolated
 tooth preparations that have an all
enamel margins

7. Contraindications:

8. Contraindications:
 an operating area that cannot be
adequately isolated

9. Contraindications:
 an operating area that cannot be
adequately isolated
 class v restorations that are not
esthetically critical

10. Contraindications:
 an operating area that cannot be
adequately isolated
 class v restorations that are not
esthetically critical
 restorations that extends into the
root surface (contraction gap)

11. Advantages

12. Advantages
 esthetics

13. Advantages
 esthetics
 conservative of tooth structure
removal

14. Advantages
 esthetics
 conservative of tooth structure
removal
 less complex when preparing the
tooth

15. Advantages
 esthetics
 conservative of tooth structure
removal
 less complex when preparing the
tooth
 low thermal conductivity (insulative)

16. Advantages
 esthetics
 conservative of tooth structure
removal
 less complex when preparing the
tooth
 low thermal conductivity (insulative)
Used almost universally

17. Advantages (continued)
 bonded to tooth structure

18. Advantages (continued)
 bonded to tooth structure
Repairable

19. Disadvantages

20. Disadvantages
may result to gap formation

21. Disadvantages
may result to gap formation
 restoration is more difficult, time-consuming,
costly

22. Disadvantages
may result to gap formation
 restoration is more difficult, time-consuming,
costly
more technique sensitive

23. Disadvantages
may result to gap formation
 restoration is more difficult, time-consuming,
costly
more technique sensitive
may exhibit more wear in areas of
high occlusion

24. Disadvantages
may result to gap formation
 restoration is more difficult, time-consuming,
costly
more technique sensitive
may exhibit more wear in areas of
high occlusion
 have a higher linear coefficient of
thermal expansion

25. COMPOSITE

26. COMPOSITE
 introduced commercially in 1962 by
Bowen of the National Bureau of
Standards

27. COMPOSITE
 introduced commercially in 1962 by
Bowen of the National Bureau of
Standards
most popular tooth colored material

28. COMPOSITE
 introduced commercially in 1962 by
Bowen of the National Bureau of
Standards
most popular tooth colored material
 consist of a continuous polymeric or
resin matrix in which an inorganic
filler is dispersed

29. Classification

30. Classification
1. Conventional

31. Classification
1. Conventional
2. Microfilled

32. Classification
1. Conventional
2. Microfilled
3. Hybrid

33. Classification
1. Conventional
2. Microfilled
3. Hybrid
.1 Flowable

34. Classification
1. Conventional
2. Microfilled
3. Hybrid
.1 Flowable
.2 Packable

35. Classification
1. Conventional
2. Microfilled
3. Hybrid
.1 Flowable
.2 Packable
4. Nanofilled

36. Composition

37. Composition
1. Organic Resin

38. Composition
1. Organic Resin – forms the matrix

39. Composition
1. Organic Resin – forms the matrix
-dimethacrylate monomer (BIS-GMA)

40. Composition
1. Organic Resin – forms the matrix
-dimethacrylate monomer (BIS-GMA)
2. Inorganic filler

41. Composition
1. Organic Resin – forms the matrix
-dimethacrylate monomer (BIS-GMA)
2. Inorganic filler
- inhibits deformation of the matrix

42. Composition
1. Organic Resin – forms the matrix
-dimethacrylate monomer (BIS-GMA)
2. Inorganic filler
- inhibits deformation of the matrix
-reduce the coefficient of thermal
expansion of the resin matrix

43. Composition
A. Organic Resin – forms the matrix
-dimethacrylate monomer (BIS-GMA)
B. Inorganic filler
- inhibits deformation of the matrix
-reduce the coefficient of thermal
expansion of the resin matrix
e.g. fused silica, crystalline quartz,
lithium aluminum silicate,
borosilicate glass

44. C. Coupling Agent

45. C. Coupling Agent
– unite the resin with the filler

46. C. Coupling Agent
– unite the resin with the filler
-stress absorber of the filler and
resin

47. 3. Coupling Agent
– unite the resin with the filler
-stress absorber of the filler and
resin
4. Initiator System

48. 3. Coupling Agent
– unite the resin with the filler
-stress absorber of the filler and
resin
4. Initiator System – activate the
setting mechanism

49. 3. Coupling Agent
– unite the resin with the filler
-stress absorber of the filler and
resin
4. Initiator System – activate the
setting mechanism
5. Stabilizers

50. C. Coupling Agent
– unite the resin with the filler
-stress absorber of the filler and
resin
D. Initiator System – activate the
setting mechanism
E. Stabilizers
F. Pigments

51. Conventional Composites

52. Conventional Composites
 contains 75-80% inorganic filler by
weight

53. Conventional Composites
 contains 75-80% inorganic filler by
weight
 average particle size 8μm
l

54. Conventional Composites
 contains 75-80% inorganic filler by
weight
 average particle size 8μm
 large size particle and
extremely hard filler

55. Conventional Composites
 contains 75-80% inorganic filler by
weight
 average particle size 8μm
 large size particle and
extremely hard filler
 rough surface structure
strontium and barium glass
(radiopaque)

57. Microfilled Composites

58. Microfilled Composites
 introduced in the late 1970

59. Microfilled Composites
 introduced in the late 1970
 polishable

60. Microfilled Composites
 introduced in the late 1970
 polishable
 smooth lustrous surface similar to
tooth enamel

61. Microfilled Composites
 introduced in the late 1970
 polishable
 smooth lustrous surface similar to
tooth enamel
 particle size is 0.01 – 0.04μm

62. Microfilled Composites
 introduced in the late 1970
 polishable
 smooth lustrous surface similar to
tooth enamel
 particle size is 0.01 – 0.04μm
 contains 35-60% inorganic filler
by weight

63.  some of physical and mechanical
properties are inferior

64.  some of physical and mechanical
properties are inferior
 wear resistant

65.  some of physical and mechanical
properties are inferior
 wear resistant
 low modulus of elasticity (allow
restoration to flex)

66.  some of physical and mechanical
properties are inferior
 wear resistant
 low modulus of elasticity (allow
restoration to flex)
 high resin content results in an
increased coefficient of thermal
expansion and lower strength

68. Use of Microfilled Composites

69. Use of Microfilled Composites
 used for low stress restorations

70. Use of Microfilled Composites
 used for low stress restorations
 buccal and lingual surfaces of class
III and class V

71. Hybrid Composites

72. Hybrid Composites
 combines the properties of
conventional and microfilled

73. Hybrid Composites
 combines the properties of
conventional and microfilled
 contains 75-85% inorganic filler by
weight

74. Hybrid Composites
 combines the properties of
conventional and microfilled
 contains 75-85% inorganic filler by
weight
 particle size is 0.4 – 1μm

75. Hybrid Composites
 combines the properties of
conventional and microfilled
 contains 75-85% inorganic filler by
weight
 particle size is 0.4 – 1μm
 physical properties is superior
to conventional

76.  predominant direct esthetic resin

77.  predominant direct esthetic resin
 have universal clinical applicability

79. Use of Hybrid Composites

80. Use of Hybrid Composites
 used in moderate stress
restorations where strength and
wear resistance are more important
than surface luster

81. Use of Hybrid Composites
 used in moderate stress
restorations where strength and
wear resistance are more important
than surface luster
Class I, class II, class IV

82. Flowable

83. Flowable
 flows into cavity due to lower
viscosity

84. Flowable
 flows into cavity due to lower
viscosity
 have lower filler content

85. Flowable
 flows into cavity due to lower
viscosity
 have lower filler content
 inferior physical properties (lower
wear resistance, lower strength)

86. Flowable
 flows into cavity due to lower
viscosity
 have lower filler content
 inferior physical properties (lower
wear resistance, lower strength)
 used in small class I, pit and fissure
sealant,marginal repair, liner

87.  easy to use

88.  easy to use
 good wettability

89.  easy to use
 good wettability
 favorable handling properties

90. Packable (Condensable)

91. Packable (Condensable)
more viscous, “thicker, stiffer feel”

92. Packable (Condensable)
more viscous, “thicker, stiffer feel”
 have filler particle feature that
prevents sliding of the filler particle
by one another

93. Packable (Condensable)
more viscous, “thicker, stiffer feel”
 have filler particle feature that
prevents sliding of the filler particle
by one another
 easier restoration of proximal
contact

94. Packable (Condensable)
more viscous, “thicker, stiffer feel”
 have filler particle feature that
prevents sliding of the filler particle
by one another
 easier restoration of proximal
contact
 similar to the handling of amalgam

95. Nanocomposites
Nanotechnology or, for short,
nanotech, refers to a field of
applied science whose theme is the
control of matter on an atomic or
molecular scale.

96.  Generally nanotechnology deals
with structures 100 nanometers or
smaller, and involves developing
materials or devices within that
size.

97. Nanocomposites are materials
that are created by introducing
nanoparticulates (often referred to
as filler) into a macroscopic sample
material (often referred to as the
matrix).

98.  After adding nanoparticulates to
the matrix material, the resulting
nanocomposite may exhibit
drastically enhanced properties.
For example, adding carbon
nanotubes tends to drastically add
to the electrical and thermal
conductivity.

99. Other kinds of nanoparticulates
may result in enhanced optical
properties, dielectric or mechanical
properties such as stiffness and
strenght.

100. CLINICAL TECHNIQUE
FOR DIRECT CLASS III,
CLASS IV AND
CLASS V
RESTORATIONS

101. Class III Tooth Preparation

102. Class III Tooth Preparation

103. Class III Tooth Preparation
 there is a choice between facial or
lingual entry into the tooth

104. Indications for Lingual Approach

105. Indications for Lingual Approach
1. to conserve facial enamel for
enhanced esthetics

106. Indications for Lingual Approach
1. to conserve facial enamel for
enhanced esthetics
2. carious lesion is positioned
lingually

107. Indications for Lingual Approach
1. to conserve facial enamel for
enhanced esthetics
2. carious lesion is positioned
lingually
3. lesion is accessible from the
lingual

108. Indications for Facial Approach

109. Indications for Facial Approach
1. The carious lesion is positioned
facially

110. Indications for Facial Approach
1. The carious lesion is positioned
facially
2. Teeth is irregularly aligned,
making lingual access undesirable.

111. Indications for Facial Approach
1. The carious lesion is positioned
facially
2. Teeth is irregularly aligned,
making lingual access undesirable.
3. Extensive caries extent into the
facial surface.

112. Indications for Facial Approach
1. The carious lesion is positioned
facially
2. Teeth is irregularly aligned,
making lingual access undesirable.
3. Extensive caries extent into the
facial surface.
4. Faulty restoration that was
originally placed at the facial.

113. Conventional Class III

114. Conventional Class III
 indicated for restorations involving
the root surface

115. Conventional Class III
 indicated for restorations involving
the root surface
1. using a No. ½, 1, 2 round bur
prepare the outline form on the root
surface

116. Conventional Class III
 indicated for restorations involving
the root surface
1. using a No. ½, 1, 2 round bur
prepare the outline form on the root
surface
2. extend the preparation into sound
walls

117. Conventional Class III
 indicated for restorations involving
the root surface
1. using a No. ½, 1, 2 round bur
prepare the outline form on the root
surface
2. extend the preparation into sound
walls
3. extend pulpally 0.75mm in depth

118. 4. The gingival/cervical and incisal
wall is perpendicular to the root
surface (box like design)

119. 4. The gingival/cervical and incisal
wall is perpendicular to the root
surface (box like design)
5. A continuous groove retention can
be prepared 0.25 mm (½ of
diameter of bur) into dentin of the
gingival and incisal walls with a ¼
round bur.

120. 6. The groove is placed at the
junction of the axial and the external
walls.

121. 6. The groove is placed at the
junction of the axial and the external
walls.
7. Clean preparation and inspect the
final preparation.

124. Beveled Conventional Class III

125. Beveled Conventional Class III
 Indicated for replacing an existing
defective restoration in the crown
portion of the tooth

126. Beveled Conventional Class III
 Indicated for replacing an existing
defective restoration in the crown
portion of the tooth
 when restoring a large carious
lesion for which the need for
increased retention and/or
resistance form is anticipated.

127. Lingual Access

128. Lingual Access
1. Use a round bur No. 1/2, 1. 2
depending on the size of the caries
to enlarge the opening sufficiently to
allow for caries removal.

129. Lingual Access
1. Use a round bur No. 1/2, 1. 2
depending on the size of the caries
to enlarge the opening sufficiently to
allow for caries removal.
2. Extend external walls to sound
tooth structure using a straight bur

130. 3. Extend the gingival and incisal
walls up to extent of caries or
location of old restoration.

131. 3. Extend the gingival and incisal
walls up to extent of caries or
location of old restoration.
Unless necessary, DO NOT:

132. 3. Extend the gingival and incisal
walls up to extent of caries or
location of old restoration.
Unless necessary, DO NOT:
 include the proximal contact.

133. 3. Extend the gingival and incisal
walls up to extent of caries or
location of old restoration.
Unless necessary, DO NOT:
 include the proximal contact.
 extend into the facial surface.

134. 3. Extend the gingival and incisal
walls up to extent of caries or
location of old restoration.
Unless necessary, DO NOT:
 include the proximal contact.
 extend into the facial surface.
 extend subgingivally

135. 4. Create an axial wall depth of
0.2mm into the dentin/DEJ
(approximately 0.75 – 1.25mm in
depth)

137. 4. Create an axial wall depth of
0.2mm into the dentin/DEJ
(approximately 0.75 – 1.25mm in
depth)
5. Axial wall is convex, following the
external contour of the tooth.

138. 4. Create an axial wall depth of
0.2mm into the dentin/DEJ
(approximately 0.75 – 1.25mm in
depth)
5. Axial wall is convex, following the
external contour of the tooth.
6. Remove all remaining infected
dentin, using a round bur or small
spoon excavator.

139. 7. Remove friable enamel at the
margins.

140. 7. Remove friable enamel at the
margins.
8. If necessary, prepare retention
(grooves or coves)

141. 7. Remove friable enamel at the
margins.
8. If necessary, prepare retention
(grooves or coves)
 prepare it along the gingivoxial line
angle, and sometimes at the
incisoaxial line angle .25 mm with a
¼ round bur.

143. 9. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.

144. 9. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.
10. Use a flame shape or round bur
resulting in a 45 degrees angle to
the external tooth surface.

146. 9. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.
10. Use a flame shape or round bur
resulting in a 45 degrees angle to
the external tooth surface.
11. Bevel width should be 0.25 to
0.5mm.

147. 12. Clean the preparation of any
debris and inspect final preparation.

148. Facial Access

149. Facial Access
 same stages and steps are followed

150. Facial Access
 same stages and steps are followed
 procedure is simplified because of
easy access

151. Modified Class III

153. Modified Class III
most used type of cavity
preparation.

154. Modified Class III
most used type of cavity
preparation.
 indicated for small and moderate
lesions or faults.

155. Modified Class III
most used type of cavity
preparation.
 indicated for small and moderate
lesions or faults.
 designed to be as conservative as
possible.

156. Modified Class III
most used type of cavity
preparation.
 indicated for small and moderate
lesions or faults.
 designed to be as conservative as
possible.
 preparation walls have no specific
shapes or forms other than an
external angle of 90 or more
degrees

157.  preparation design appears to be
scooped or concave

159.  preparation design appears to be
scooped or concave
1. Use a 1/2, 1, 2 round bur, point of
entry is within the incisogingival
dimension of the lesion,
perpendicular to the enamel
surface.

160.  preparation design appears to be
scooped or concave
1. Use a 1/2, 1, 2 round bur, point of
entry is within the incisogingival
dimension of the lesion,
perpendicular to the enamel
surface.
2. Remove all remaining caries or
defect.

161. 3. No attempt is made to create a
uniform axial wall.

162. 3. No attempt is made to create a
uniform axial wall.
4. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.

163. 3. No attempt is made to create a
uniform axial wall.
4. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.
5. Use a flame shape or round bur
resulting in a 45 degrees angle to
the external tooth surface.

164. 3. No attempt is made to create a
uniform axial wall.
4. Place cavosurface bevel or flare at
the enamel except at the gingival
margin area.
5. Use a flame shape or round bur
resulting in a 45 degrees angle to
the external tooth surface.
6. Bevel width should be 0.25 to
0.5mm.

165. 7. Clean the preparation of any
debris and inspect final preparation.

167. Class IV Tooth Preparation

169. Class IV Tooth Preparation
 preoperative assessment of
occlusion is very important
(placement of margin in noncontact
areas)

170. Class IV Tooth Preparation
 preoperative assessment of
occlusion is very important
(placement of margin in noncontact
areas)
 shade selection is more difficult

171. Class IV Tooth Preparation
 preoperative assessment of
occlusion is very important
(placement of margin in noncontact
areas)
 shade selection is more difficult
 preparation is similar to Class III
except that the preparation for class
IV is extended to the incisal angles

173. Class V Tooth Preparation
Conventional

174. Class V Tooth Preparation
Conventional
 the feature of the preparation
include a 90 degree cavosurface
angle, uniform depth of the axial line
angle, and sometimes, groove
retention from.

175. Class V Tooth Preparation
Conventional
 the feature of the preparation
include a 90 degree cavosurface
angle, uniform depth of the axial line
angle, and sometimes, groove
retention from.
 conventional design is indicated
only for portion of the lesion
extended onto the root surface

176. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.

177. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to
tooth surface, this should result to a
90 degree cavosurface.

178. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to
tooth surface, this should result to a
90 degree cavosurface.
3. Axial depth is 0.75 mm

179. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to
tooth surface, this should result to a
90 degree cavosurface.
3. Axial depth is 0.75 mm
-strength of preparation wall

180. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to
tooth surface, this should result to a
90 degree cavosurface.
3. Axial depth is 0.75 mm
-strength of preparation wall
-strength of composite

181. 1. Use a tapered fissure (No. 700,
701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to
tooth surface, this should result to a
90 degree cavosurface.
3. Axial depth is 0.75 mm
-strength of preparation wall
-strength of composite
-placement of retention groove

182. 4. Axial should follow contour of the
tooth.

183. 4. Axial should follow contour of the
tooth.
5. Extent of outline form is dictated
by the carious lesion extent.

184. 4. Axial should follow contour of the
tooth.
5. Extent of outline form is dictated
by the carious lesion extent.
6. Remove remaining carious lesion

185. 4. Axial should follow contour of the
tooth.
5. Extent of outline form is dictated
by the carious lesion extent.
6. Remove remaining carious lesion
7. Prepare retention groove (similar
to Class III preparation)

186. 4. Axial should follow contour of the
tooth.
5. Extent of outline form is dictated
by the carious lesion extent.
6. Remove remaining carious lesion
7. Prepare retention groove (similar
to Class III preparation)
8. Clean preparation

187. Beveled Conventional Class V

188. Beveled Conventional Class V
 Indications

189. Beveled Conventional Class V
 Indications
1. replacement of defective class V
restorations

190. Beveled Conventional Class V
 Indications
1. replacement of defective class V
restorations
2. large carious lesion

191. Beveled Conventional Class V
 Indications
1. replacement of defective class V
restorations
2. large carious lesion
 exhibits 90 degrees of cavosurface

192. Beveled Conventional Class V
 Indications
1. replacement of defective class V
restorations
2. large carious lesion
 exhibits 90 degrees of cavosurface
 axial wall depth is uniform (0.2mm
or 0.5 when retention groove is to
placed)

193.  groove is not indicated when
periphery of tooth preparation is
located in enamel.

194.  groove is not indicated when
periphery of tooth preparation is
located in enamel.
 remove all infected dentin

195.  groove is not indicated when
periphery of tooth preparation is
located in enamel.
 remove all infected dentin
 clean preparation

196. Modified Class V

197. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel

198. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel
 no effort to prepare a butt-joint

199. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel
 no effort to prepare a butt-joint
 no retention groove

200. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel
 no effort to prepare a butt-joint
 no retention groove
 lesion is scooped out

201. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel
 no effort to prepare a butt-joint
 no retention groove
 lesion is scooped out
 preparation has divergent wall

202. Modified Class V
 indicated for small and moderate
lesion and lesion entirely in the
enamel
 no effort to prepare a butt-joint
 no retention groove
 lesion is scooped out
 preparation has divergent wall
 axial wall does not have uniform
depth

203.  prepare tooth with round or elliptical
instrument

204.  prepare tooth with round or elliptical
instrument
 preparation is extended no deeper
than 0.2 mm

205.  prepare tooth with round or elliptical
instrument
 preparation is extended no deeper
than 0.2 mm
 no effort is made to prepare a 90
degree cavosurface margins.

206.  prepare tooth with round or elliptical
instrument
 preparation is extended no deeper
than 0.2 mm
 no effort is made to prepare a 90
degree cavosurface margins.
 infected enamel is removed with a
round bur or excavator.

208. Class V Tooth Preparation for
Abrasion/Erosion

209. Class V Tooth Preparation for
Abrasion/Erosion
Abrasion – often V-shaped is a loss
or wearing away due to mechanical
forces.

210. Class V Tooth Preparation for
Abrasion/Erosion
Abrasion – often V-shaped is a loss
or wearing away due to mechanical
forces.
Erosion- often a saucer shaped
notch as a result of chemical
dissolutions

211. Abfraction/Idiopathic Erosion- may
occur as a result of flexure of
cervical area under heavy occlusal
stress. This occurs as a notched
defect.

212. Abfraction/Idiopathic Erosion- may
occur as a result of flexure of
cervical area under heavy occlusal
stress. This occurs as a notched
defect.
Modified tooth preparation is used
for this types of defects.

213. Acid Etching

214. Acid Etching
A physical process that creates a
microscopically rough enamel
surface (enamel tags)

215. Acid Etching
A physical process that creates a
microscopically rough enamel
surface (enamel tags)
 first successful technique developed
to bond dental materials to tooth
structure

216. Acid Etching
A physical process that creates a
microscopically rough enamel
surface (enamel tags)
 first successful technique developed
to bond dental materials to tooth
structure
 acid used id 37% ortho-phosphoric
acid

217.  sometimes referred to as
conditioner

218. Enamel Etching

219. Enamel Etching
Acid

220. Enamel Etching
Acid
 37% ortho-phosphoric acid

221. Enamel Etching
Acid
 37% ortho-phosphoric acid
 dissolves the periphery of enamel
rod, or the core of the rods or both

223.  over-etching results to formation of
crystals (precipitates) that inhibits
bonding

224.  over-etching results to formation of
crystals (precipitates) that inhibits
bonding
 built-in quality control check – if
properly etched it appears frosty or
chalky white.

225.  over-etching results to formation of
crystals (precipitates) that inhibits
bonding
 built-in quality control check – if
properly etched it appears frosty or
chalky white.
Time

226.  over-etching results to formation of
crystals (precipitates) that inhibits
bonding
 built-in quality control check – if
properly etched it appears frosty or
chalky white.
Time
 15-30 seconds permanent tooth

227.  over-etching results to formation of
crystals (precipitates) that inhibits
bonding
 built-in quality control check – if
properly etched it appears frosty or
chalky white.
Time
 15-30 seconds permanent tooth
 twice as long for deciduous

229. Dentin Etching

230. Dentin Etching
Acid

231. Dentin Etching
Acid
 37% ortho-phosphoric acid

232. Dentin Etching
Acid
 37% ortho-phosphoric acid
 removes the smear layer from the
surface of the of the dentin as well
as the plugs of material forces into
dentinal tubules during cavity
preparation.

234.  decalcifies a layer of dentin several
microns thick

235.  decalcifies a layer of dentin several
microns thick
Time

236.  decalcifies a layer of dentin several
microns thick
Time
10-15 seconds

238. Primer

239. Primer
 similar to the low viscosity resin
used in enamel bonding.

240. Primer
 similar to the low viscosity resin
used in enamel bonding.
 primers are hydrophilic (tolerant of
moisture)

241. Primer
 similar to the low viscosity resin
used in enamel bonding.
 primers are hydrophilic (tolerant of
moisture)
 contains a volatile solutions
(acetone) to thin the organic
chemicals and improves the wetting
of the etched surface

242.  primer flows into:

243.  primer flows into:
-surface irregularities of etched
enamel

244.  primer flows into:
-surface irregularities of etched
enamel
-open tubules and around collagen
fibers of etched dentin

245.  primer flows into:
-surface irregularities of etched
enamel
-open tubules and around collagen
fibers of etched dentin
 primers do not set on their own, et
when adhesive is applied

246. Adhesives

247. Adhesives
 a low viscosity resin

248. Adhesives
 a low viscosity resin
 dentin adhesives contain hydrophilic
chemicals, but less than in primers

249. Adhesives
 a low viscosity resin
 dentin adhesives contain hydrophilic
chemicals, but less than in primers
 adhesive sets

250. Adhesives
 a low viscosity resin
 dentin adhesives contain hydrophilic
chemicals, but less than in primers
 adhesive sets
 renders the tooth surface glossy

251. Two-step Bonding System

252. Two-step Bonding System
 the primer and the adhesive have
been combined

253. Two-step Bonding System
 the primer and the adhesive have
been combined
One-step/Self Etching System

254. Two-step Bonding System
 the primer and the adhesive have
been combined
One-step/Self Etching System
 etches, primes and bonds (has
adhesives) the tooth structure all at
once

255. Two-step Bonding System
 the primer and the adhesive have
been combined
One-step/Self Etching System
 etches, primes and bonds (has
adhesives) the tooth structure all at
once
 sometimes does not effectively etch
the enamel.

257. Restorative Technique

258. Restorative Technique
1. Determine shade of tooth

259. Shade Selection:
After caries removal
and cavity preparation
shade selection was
done using shade
guide

260. Restorative Technique
1. Determine shade of tooth
2. Clean the tooth preparation using
a slurry of pumice, polishing cup.

262. Restorative Technique
1. Determine shade of tooth
2. Clean the tooth preparation using
a slurry of pumice, polishing cup.
3. Isolate the tooth, preferably with a
rubber dam or cotton rolls.

263. Isolation of the Teeth:
Rubber dam isolation
technique was used to
keep the prepared teeth
from saliva, blood,
debris and other fluids.

265. Restorative Technique
1. Determine shade of tooth
2. Clean the tooth preparation using
a slurry of pumice, polishing cup.
3. Isolate the tooth, preferably with a
rubber dam or cotton rolls.
4. Protect adjacent unprepared tooth
from the acid etchant with a
polyester strip apply the wedge.

267. 5. Apply the gel etchant 0.5 beyond
the prepared margins onto the
adjacent unprepared tooth.

268. 5. Apply the gel etchant 0.5 beyond
the prepared margins onto the
adjacent unprepared tooth.
6. Etchant is left undisturbed for 15-
30 seconds.

269. Etching Procedure

270. 5. Apply the gel etchant 0.5 beyond
the prepared margins onto the
adjacent unprepared tooth.
6. Etchant is left undisturbed for 15-
30 seconds.
7. The area is washed to remove the
etchant. Same amount of time as
etching time.

271. 8. Dry the tooth structure, if dentin is
exposed, do not air dry. Use cotton
pellet, disposable brush or tissue
paper to remove excess water.

273. 8. Dry the tooth structure, if dentin is
exposed, do not air dry. Use cotton
pellet, disposable brush or tissue
paper to remove excess water.
9. Bonding system is applied on all
tooth structure that has been etched
with a microbrush or other suitable
applicators

274. 10. Air bonding system to thin out
coating.

275. 10. Air bonding system to thin out
coating.
11. Cure, follow manufacturer's
direction.

276. Application of
Bonding Agent:
Application of
the bonding
agent and then
cured for 10
seconds.

277. 10. Air bonding system to thin out
coating.
11. Cure, follow manufacturer's
direction.
12. Incrementally place composite
material and cure.

278. Filling

279. Filling & Packing

280. Curing Of the
Composite:
The material is cured
using the light curing
machine for 20
seconds for every
increment of
composite that was
placed.

281. 10. Air bonding system to thin out
coating.
11. Cure, follow manufacturer's
direction.
12. Incrementally place composite
material and cure.
13. Finish and Polish

282. Finishing and
Polishing:
The use of polishers
with enhancers and
polishing paste were
done after the
trimming of the
excess composites.

283. Finishing & Polishing

284. BEFORE AAFFTTEERR
Before the restoration
procedure.
After restoring with Composite
Resin Material