The silicone index technique for restoring anterior teeth with multi-layered direct composites has existed since the 1990’s. More recently, injectable procedures with flowable-type composites have also been introduced, and these too have enjoyed good initial clinical success. However, the major drawbacks of these two techniques are evident when they are used to treat multiple teeth such as in Tooth Wear/Erosion cases. In such instances, achieving good contact points, tooth form, and cleaning up excess composite flash in the proximal and margin areas, can be difficult and very time consuming.
With the expansion of CAD-CAM technologies, a new application has evolved to allow a hybrid approach between digitally designed and made restorations, and the conventional silicone index “free-hand” technique. This new approach allows for the use of strong and wear resistant materials together with the accuracy that CAD-CAM can offer. This hybrid technique also allows for the conservatism, artistry and cost effectiveness that direct composites provide.
In this short presentation, Dr Mandikos will outline a new, innovative technique to involve CAD-CAM with already known direct procedures, to conservatively, efficiently, and aesthetically restore anterior teeth with composite resin. The materials and technique will be demonstrated with case examples.
1. The gold standard for aesthetic anterior composites is a multilayered technique.
2. Multilayering can applied by a partially digital and partially conventional technique.
3. The clinical procedures for multilayering using digital scanning, CAD CAM and hand finishing are described.
4. A 6-year follow-up of the digital approach is presented, together with complications.