These large Class II amalgams realistically represent a situation where one could conservatively crown the tooth or not, given the amount of residual tooth structure. The patient came to see us as she not only wanted to remove her amalgams, she wanted us to directly restore them with composite resin in this case, achieving as “invisible” a result as possible.
Preparations involved removal of a stained vertical hairline fracture on 27D marginal ridge and conservative cavosurface margin bevels before micro air abrasion using 27 micron aluminum oxide). Tooth 27DO’s marginal ridge was freehand-restored, but we tried Greater Curve’s Anatomically-Designed Tofflemire System (Aluro) on tooth 26. There is a bit of a void on the ML line angle of 26, where a sectional matrix tension ring typically seals, but the cervical seal, adaptation and contact strength were perfect after placement of Sycamore wedges. I haven’t used Tofflemires in a long time, but this system required virtually no clean-up, just a minor reshaping of line angles, and it was done! Simple and effective.
The restorations were layered using a single shade of Cosmedent Renamel Nano Plus and fissures characterized using Cosmedent Creative Color Dark Brown.
All in all, it’s a good day, because it’s not every day that you can make something tainted seemingly virgin again.
Clarrie x
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