We all have had large non-carious cervical lesions to restore on the facial or buccal surfaces of teeth. The challenge in finishing them is usually over adjusting when removing the excess in two directions (cervical 1/3 and facial 1/3). This often results in a less than desirable root form when finished. I have always used this end (see photo) of the composite instrument to place composite and condense it when restoring posterior Class II preparations. I have discovered that it is the perfect shape for smoothing down the last application of composite on large Class V lesions. When held against the cavosurface margin to the gingival margin it shapes the composite so nicely that there remains almost no other finishing to be completed.


Post a Comment

Comments

Commenter's Profile Image J Koch
December 28th, 2012
What is the name/brand of the composite instrument you are using??
Commenter's Profile Image Barry Polansky
December 28th, 2012
Thanks for the tip (no pun intended) MaryAnne. We have been using a lot of pink composite lately when the lesion extends cervically. The results have been excellent even at the juncture between the white and pink.
Commenter's Profile Image Ben Amini
December 28th, 2012
Barry, do you use pink comp from Clinician's Choice? if not which brand? Thank you
Commenter's Profile Image Gerald Benjamin
December 29th, 2012
A large percentage of these lesions will demonstrate staining and/or leakage over time at the gingival margin using the mentioned technique. The best way to avoid this problem is to place a Contour Strip (Ivoclar) to eliminate microleakage during bonding. Additional hints are to air abrade the cervial lesion and to restore with a Microfill composite (Cosmedent's Renamel). Lastly, be certain to equilibrate the tooth to eliminate traumatic occlusion.
Commenter's Profile Image Patrick Lum
January 7th, 2013
Gerald Benjamin's comment re: the benefits of air abrasion are spot-on. Use of AA ensures that the underlying tooth surface is not contaminated with debris, so that the resulting bond has maximal strength. Use of a self-etching bond ensures that no post-restorative sensitivity will result. To remove microleakage due to crevicular fluid secretion as a potential problem, I pack retraction cord prior to restoring all of my cervical lesions. And none of these lesions develop in the absence of some sort of occlusal trauma that is occuring, typically in lateral excursions, so that must be addressed as the root causation (no pun intended).
Commenter's Profile Image Klugman Robert
January 31st, 2015
Keep up the good advice.