class iv indications
- Carious lesion involving the incisal edge or undermines the enamel of the incisal edge an anterior tooth.
- Trauma- Fracture involving one or both incisal angles of an anterior tooth.
assessment of carious lesions for class iv:
* Determine?
* Evaluate extent of?
* radio?
* Determine size of?
* Determine shade of?
- Determine vitality.
- Evaluate extent of caries and presence of other lesions or defective restorations on the tooth.
- Examine radiographs for periapical lesions.
- Determine size of the pulp chamber.
- Determine shade of tooth and adjacent teeth using Vita shade guide.
assessment of trauma for class iv
- Determine cause of fracture and time (history) of occurrence.
- Determine vitality.
- Evaluate extent of fracture and integrity of the tooth as well as
discoloration. - Determine presence of carious lesions or defective restorations on
the tooth. - Examine tooth/radiographs for root fractures, buccal/lingual plate
fractures, and integrity of adjacent teeth.
caries/ trauma prep
* Anesthetize?
* Isolate tooth?
* Remove unsupported enamel with?
* Remove all caries with?
* Place a liner (RMGI/CaOH) if preparation is?
* retentin points?
* Bevel?
-lingual and interproximal margins?
- facial surface?
- Anesthetize tooth
- Isolate tooth- Rubber Dam, Isovac, Cheek Retractor.
- Remove unsupported enamel with carbide/diamond bur.
- Remove all caries with largest round bur that will fit in the space
- Place a liner (RMGI/CaOH) if preparation is within 0.5 mm of the
pulp. - Place retention points (if necessary).
- Bevel all enamel margins with a medium grit diamond bur:
- Place 45o bevel on lingual and interproximal margins.
- Place long, shallow bevel on facial surface.
class iv restoration:
* shade verification?
* interproximal matrix?
* Etch/
- enamel can be etched for?
- dentin must not be etched for?
* Dry? dentin?
- Verify shade- Place a small amount of composite on facial surface of tooth and light cure.
- Place mylar matrix strip between adjacent teeth and carefully wedge in place.
- Etch surface of tooth:
- enamel can be etched for 30 seconds or longer.
- dentin must not be etched for longer than 15 seconds.
- Dry excess water from enamel surface; dentin surface must remain moist to ensure maximum bond strength
restoration:
* Bonding agent applied to?
* Air dry for?
* Second coat?
* Air dry?
* Light cure?
- Bonding agent applied to all enamel and dentin surfaces
- Air dry for 5 seconds with gentle stream from air/water syringe.
- Second coat of bonding agent applied.
- Air dry for 5 seconds.
- Light cure all areas of tooth for 20 seconds.
restoration:
* Place first increment of composite to restore which surface?
* Cure for?
* Place second increment of composite to restorewhich surface?
- Include what?
- Place developmental grooves on?
- Place proper contour of tooth to include all?
* Cure for?
- Place first increment of composite to restore most lingual surface of the tooth to include incisal edge.
- Cure for 40 seconds.
- Place second increment of composite to restore the labial surface of the tooth:
- Include the contact and incisal angle to mirror adjacent tooth surface.
- Place developmental grooves on facial surface of tooth.
- Place proper contour of tooth to include all line angles.
- Cure for 40 seconds.
finishing restoration
* Final shaping of facial surface is accomplished with a?
* Lingual surface is shaped with ? burs on a slowspeed handpiece (< 10,000 rpm) and a ? bur (highspeed).
* Occlusion is adjusted with?
- Final shaping of facial surface is accomplished with a 7902 finishing bur.
- Lingual surface is shaped with #4, 6 carbide burs on a slowspeed handpiece (< 10,000 rpm) and a 7460 finishing bur (highspeed).
- Occlusion is adjusted with articulating paper and #4, 6 carbide burs on a slowspeed handpiece
soflex discs
polish of restoration
- Soflex Discs are used to finish and polish restoration.
- a series of four disc (yellow, light orange, orange, dark orange)
- Do not use the dark orange disc! It is too course and will remove
composite very quickly even on slowspeed. - break the spine of the discs before use.
- always use the discs wet and at very low rpm, creating a slurry.
- avoid holding the disc flat against the tooth. This will remove
tooth anatomy, hold at 45o angle. - polish with the orange and light orange removing all scratches.
diacomp points
polish of restoration
- Polish with Diacomp points.
- green Diacomp points (wet, slowspeed)
- white Diacomp points (wet, slowspeed)
- Finish polish with yellow Soflex disc
- Remove excess composite from margins and interproximal areas with #12 surgical blade.
- Optiguard may be placed and cured to seal restoration
