This video demonstrates the complete procedure for placing composite dental restorations, including matrix band placement for proximal spaces, phosphoric acid etching to prepare the tooth surface, bond application as adhesive, composite placement in 2-3mm increments with condensation, and final bite verification using articulating paper to ensure proper occlusion.
Deep Dive
Prerequisite Knowledge
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Where to go next
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Deep Dive
Composite instruments and materialsAdded:
okay when we do composite restorations once we've prepped the tooth and rinse and dried we're ready to place our restoration what we do is we have to place a matrix being on the tooth this is to hold the restoration inside of the tooth on the proximal spaces so the whole thing is disposable all right looks like that's called matrix band then we have to use a wooden wedge it's really little it's also disposable this is to push the matrix band up against the contour of the tooth in the interproximal spaces without it we would get a restoration overhang okay once we have that place I guess for anteriors we can't really use this matrix band it's the wrong shape so we have to use something called a Mylar strip it's a clear pleat piece of plastic also disposable almost impossible to keep track of because it's so clear then once we got our matrix bands placed we're ready to prep the tooth for the filling first we need to use our H this is phosphoric acid this cleans and Ruffins the surface of the dentin and the enamel opens up the namo tubules and creates a frosty like appearance gets everything prepped for our bond so with our bond there's different types this is single-use op de bonne solo plus when it's out of the package with a micro brush it looks like this okay you also have a little humble there's also bulk types of brands bond there's also bulk types of composite what those would go in is something called a Dappen dish the Dappen dish is just used to hold your materials and to filter the UV light to keep the materials from setting up so it should have some kind of orange cover or if it doesn't have an orange cover and you have one that's disposable you can always put a piece of 2x2 gauze over the top to block the UV light so once we've h the tooth I guess I need to go back once we've edged the tooth we leave it on for 30 seconds for enamel 15 seconds for dentin then you rinse for as long as you left it on then you dry but you need to make sure to not the truth because you could desiccate it at this point once this is dry it cannot get wet again or we have to go back to this step and start over once it's rinsed and dried then we use our bond pay our bond is kind of like our tooth glue it has acetone in it and bonding agents for our composite so you use a micro brush with it that one's kind of gross looking micro brush in there okay the dentist will dip the micro brush in and then they'll swirl it around in the tooth and get the bond all over every surface of the prep and then what you need to do before we cure it is we need to air thin and this is for two reasons one is to to thin the bond over the entire prep of the tooth so that way it doesn't pool at the bottom and it gets up on to the walls the other reason is to dry out the acetone that's why it smells like a nail salon when you do that so once it's air thinned then we would like hear it okay this is the light here is a UV light it is dangerous for your eyes so please don't look at it don't let anybody else in the room look at it it should have some type of orange cover if it doesn't then put your hand over it before you turn it on that way nobody can see it all right so once we've fetched rinsed dried and bond everything cure then the truth will be prepped and ready for composite so this is a composite gun this is not disposable this is autoclavable this is a composite car pool this one is one-time use it's disposable so this goes in here the dentist would squeeze the trigger all right and squeeze Baumer sweet squeeze composite into the tooth then you would hand the dentist the condenser the condenser is to pack the material down into the tooth that has a rounded tip on both sides okay that's to pack the material down into the tooth you might need to hold a two by two at this point in case they need to scrape some out and you need to grab it off of them the instrument then you light here again then composite then condense here we do that in two to three millimeter increments until the tooth is completely built up we can also use so this one is the condensers for posterior teeth only we can also use a ball burnisher whatever type of Rhenish of the dentist wants to use this packs the material while creating anatomy we also have the plastic so the plastic is flat on both ends this is for composite restorations on anterior teeth this is just because our anterior teeth are very flat in shape and so we can't really use around instrument to pack the material we have to have me use something that matches the actual shape of the tooth this often times my students gets confused with the interproximal carver okay so you can see the two the interproximal carver which is this one right here is sharp and it's for carving metal restorations alright this plastic one is not sharp if you were to drag it against your skin it wouldn't cut you and this is for composite restorations think of plastic restorations a plastic thumb instrument we also have a spoon excavator if you can see the tip there it's shaped like a spoon it's like a little scoop it's used for digging out decay decay is very soft it's also used for digging out things like temporary restorations a couple other materials if we have a prep that is too deep we have two different types of liners we have a temporary liner this is die collet as a temporary liner it goes under temporary restorations because it is not meant to stay permanently within the tooth okay you don't actually have a permanent liner but a permanent liner would be a glass ionomer and it would be the most common as Victor Bond and it would go under a permanent restoration so temporary liners go under temporary restorations permanent liners go under permanent restorations this would be to protect the pulp from things like heat and to to give dental regeneration to help inhale the tooth this is just bulk composite this is an alternative to the little disposable composite carpools that we have these little disposable ones can be very wasteful these little guys they can be very wasteful because we don't always necessarily use all the composite inside of there but it's one-time use only so the bulk composite would also go with the Dappen dish you put the bowl composite in the definition and make sure that you protect it from the UV light so that it doesn't hurt anything so once the filling is placed it is completed everything is done the last thing we need to do is check the bite this is an articulating paper holder hey that's the articulating paper holder this is articulating paper the articulating paper has ink on both sides and what the dentist says is they ask the patient to tap tap-tap grind left and right and they're trying to find the way that the teeth are meant to bite together it's very specific science to how each tooth fits with another one if it's done wrong or a restoration is too high then it can cause patients pain down the road so it's important that we get the bite right this is the articulating paper holder
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