In a recent case study, Dr Monaldo Saracinelli demonstrates how beautiful aesthetics can be restored using a no-prep direct composite technique; highlighting 5 important things to remember when working with composite restorations.
Who is Dr Monaldo Saracinelli?
Dr Monaldo Saracinelli is an honorary member of the StyleItaliano team.
He lectures on direct and indirect aesthetic composite restorations in anterior and posterior teeth in Italy and abroad. He was a student of Prof. Fabio Toffenetti and Riccardo Garberoglio and became student trainer in Conservative Dentistry at the Instituto Policattedra di Discipline Odontostomatologiche Università degli Studi Di Siena” in 1986. He then took on the role of teaching dental technicians on the subject of Biomeccanica masticatoria e Protesi applicate. He has been an active member of the Accademia Italiana di Conservativa (AIC) since 2005 and of the Italian Academy of Aesthetic Dentistry (IAED) since 2011.
Here are 5 simple (but important) things to remember when working with composite restorations:
1. Patients Believe White Means Healthy
Dr Monaldo Saracinelli highlights how today, patients ‘strongly believe that white means healthy’. In the case, he improves his patients smile with a combination of whitening and composite.
He recommends prior to composite restorations to remember this, choosing to achieve a better (whiter) shade as a first step. He opts to use White Dental Beauty tooth whitening gels, selecting the home whitening protocol of 10% Carbamide peroxide. This concentration is classed as the original concentration of tooth whitening and depending on the patients preference can be worn 2-4 hours or overnight.
After this, he opts to use White Dental Beauty Professional CompoSite system, which has a colour palette specifically which comprises of high value shades of white - making it ideal for restorative work on bleached or naturally white teeth.
2. Fresh Composite Buttons Can Assist Colour Selection If Used Correctly
Dr Monaldo Saracinelli suggests the use of fresh composite buttons that match the original colour quite well. When placing the composite buttons, he suggests trying to imagine the amount of material you need, as he says this will help you better understand the opacity and colour saturation of the future restoration.
Using two of the lighter shades from the White Dental Beauty Professional CompoSite system (Si0.5 and Si1), Dr Saracinelli notes how shade selection should always take place before isolation with the rubber dam (to prevent incorrect dehydration of the teeth and incorrect colour selection)
He also notes the importance of curing the composite buttons, stating how sometimes the photo-activator inside can change the final colour (and the actual outcome).
3. The Most Accurate Colour Perception Comes From Light Source Which Reproduces Daylight
Using a consistent light source with a light temperature between 5,500 and 6,600 kelvin (pure daylight) is vital in order to observe the true shade of the tooth. It also assists with dental photography, allowing the user to accurately capture the hue, value and chroma of the tooth. With a 5,500°K - 6,600°K light source, the user will find the colour selection process easier and more accurate.
For optimum results during colour selection, it is suggested to turn the chair light off and use a tool such as the Smile Lite Complete as Dr Monaldo Saracinelli does in this case.
4. A curved matrix assists with creating a natural tooth shape
To create a natural and beautiful buccal shape and contour for UR1 and UL1, Dr Monaldo Saracinelli opts to use the Unica Matrix system by Polydentia.
Thanks to its contoured shape, these matrices adapt with ease to the different morphologies of anterior teeth, hugging the cervical and interproximal margins.
Dr Monaldo Saracinelli highlights how use of this matrix makes the final shape predictable, allowing for better time management, easily providing a natural emergence profile.
5. Leave a thin space for a high quality final enamel layer to add optical depth to the restorations
For the first layer Dr Monaldo Saracinelli uses the 0.5 shade of the White Dental Beauty Professional CompoSite system to model the inner mamelon anatomy.
After this he recommends leaving a thin space for the final enamel layer to add optical depth to the restorations. He opts for the enamel from the White Dental Beauty CompoSite system which boasts a natural fluorescence and a non-sticky consistency.
The final result (pictured above) immediately improves the patients smile, resulting in amazing long-term aesthetics.
Read Dr Monaldo Saracinelli's case study in full 'Aesthetics & Function – A No Prep Direct Composite Case' by clicking the button below.