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Midline: A Simplified Approach For Sustained Success


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From the AACD's Journal of Cosmetic Dentistry, here's a slideshow outlining the steps needed for successful composite resin placement.

  • A bulk fill (Filtek Supreme Ultra) with bilateral transenamel illumination using two powerful lights simultaneously and carved to full contour is a better approach to controlling shrinkage than with layering…and the science confirms it.
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Midline: A Simplified Approach For Sustained Success

  1. 1. Steps for Direct Posterior Composite Resin Placement
  2. 2. A Simplified Approach for Sustained Success by Jason Smithson, BDS, DipRestDent RCS (Eng) taken from the Journal of Cosmetic Dentistry, Vol. 27 Issue 3
  3. 3. Step 1: Isolation Isolation in quadrants utilizing a clamp and rubber dam
  4. 4. Step 2: Preparation Removal of old dentistry
  5. 5. Step 2: Preparation After rendering cavity as caries-free, enamel margins are beveled
  6. 6. Step 2: Preparation Cavity is etched, and a dentin-bonding agent is placed and polymerized for 30 seconds
  7. 7. Step 2: Preparation Flowable composite is placed, then polymerized for 40 seconds
  8. 8. Step 3: Bonding Composite resin is laid out in 2mm x 1mm increments in the light well of a composite heater
  9. 9. Step 3: Bonding Resin carried to the cavity
  10. 10. Step 3: Bonding Bend microbrush at desired angle to aid in ergonomics, and used in patting motion to condense resin
  11. 11. Step 4: Resin Build-Up The dentin mass is modeled on a cusp-by-cusp bases, oblique layering and polymerizing each separate cusp to reduce “C-Factor” stresses
  12. 12. Step 5: Finishing Enamel tints are applied. The enamel shade composite is built up. Each increment is polymerized for three seconds.
  13. 13. Step 5: Finishing Initial and Final polishing
  14. 14. Result Final restoration and esthetic integration
  15. 15. Read more in the Journal of Cosmetic Dentistry by visiting