Class IV buildups

Patent No. US DA 439,667 S

Class IV Buildups

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Class IV Composite Buildups

There are occasions that we need to push the limits of composite:

Patients fracture anterior teeth which need to be repaired esthetically and rapidly.
Finances are a concern. Our patients can not afford or chooses not to afford the protection of full coverage at this time.
There are other teeth that have more pressing concerns.

Using Teflon tape and the Contour Wedge, the dentist has the tools to vertically build a tooth that looks like a tooth. The dentist has the ability:

To build teeth with normal rounded profiles.
To position snug contacts precisely.
To visualize all aspects of the restoration. There is no mylar strip to hamper access.
To get it right the first time. The need to add additional composite here and there is less likely. Traditional wedge and mylar strip tend to straight line the composite which needs to be corrected secondarily.

Composite Buildups of Tooth #7

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	A	Patient had a large mesial incisial composite on tooth #7 which had fractured off. The distal composite was also faulty. Once all existing composite was removed, and the enamel taped to create a good bonding surface, little remained of the tooth.
	B	Contour Wedges in place. Neighboring teeth have been isolated with Teflon tape. Note that the gingiva has been compressed and is blanched. No gingival seepage will contaminate the surface to be bonded.
	C	Tooth #7 has been layered with color coordinated opaque and incisial composite.
	D	Final restoration. Patient was advised that this tooth may need a crown. Time will tell.

Composite buildups of teeth #'s 8, 9, & 10

This patient had decay in multiple teeth. He was not in position to do all his work within the same calendar year. Decay in the posterior teeth was more immediate concern. Understandably, my patient wanted to be able to smile freely while his work was being completed on the posterior teeth. Transitional composites were placed on teeth #'s 8, 9, & 10. Crowns will be placed on these teeth at a later date.

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	A	Preoperative condition of the upper anterior teeth.
	B	Tooth #8 has been isolated with Teflon tape, and the Contour Wedges. (Tooth #7 is a porcelain crown so there is no need for the Teflon tape.) Note that the Contour Wedges follow the curvature of the tooth. The gingiva is compressed, blanched, and removed from the operative field. Retraction cord was placed in the sulcus at the labial.
	C	Tooth was over built slightly, and ready for cut back. Access to the tooth was unhampered because no mylar strips were needed.
	D	Finished transitional composites on teeth #'s 8, 9, & 10. Patient was pleased with the results. Can now turn our attention to the posterior teeth.

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	A	Patient has only five remaining lower teeth. Teeth are opposed by a denture, and she wears a lower partial. She doesn't want to spend a lot of money. She wants to keep her remaining teeth, and wants to get rid of her "dark" tooth. # 23 has a healthy root canal which has been restored with a large broken down amalgam on the lingual.
	B	# 23 has been sectioned near the gingiva. Teflon tape has been draped around the neighboring teeth. Contour Wedges have been shaped and burnished. Post space has been made.
	C	A Whaledent Fiber White Post has been cemented with tooth shade Panavia 21.
	D	Esthet -X A-40 provides the base.
	E	Esthet-X B-2 provides the final layer. [ Neighboring teeth were opaque so there was no need for a translucent layer.]
	F	Final restoration for # 23. I believe this restoration has a reasonable chance at longevity. It is opposed by a denture.