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Techniques to Remedy Surface Defects


Simple, Successful Composite Repairs
Corky Willhite, DDS, FAGD, AACD Accredited Fellow
Illustrations by Zach Turner
When patients present with esthetic composite restorations requiring
repair, or if defects are detected during the direct restorative process, a
  simple technique for repairing composite defects is invaluable. This
basic technique can be varied slightly to correct composite defects at a
  couple of different points in the restorative process: initial placement
                            and post-treatment.

     These procedures can remedy defects involving pits and voids,
fractures, white lines, and improper contouring. Key to this technique’s
success is ensuring that the repair is completed prior to any polishing if
the procedure is to be accomplished during the initial fabrication of the
restoration. If the surface has already been polished, added composite
 will not bond to the surface. Therefore, it will be necessary to roughen
      the composite surface in order to repair the composite defect.
Additionally, for the post-treatment repair of microhybrid and nanohybrid
  restorations more than one day old, a micro-etching sandblast should
  be applied to the defective area prior to etching with 35% phosphoric
acid. For microfill repairs, this author does not recommend sandblasting.
    Because the microfill composites contain such small and uniform
 particles, micro-etching decreases the mechanical retention created by
                                 the bur marks.




 Adapted from the full article, which originally appeared in the AACD’s
            Journal of Cosmetic Dentistry, Fall 2010 issue.
             For more information, visit www.AACD.com.
Close-up view showing two defects
                                     on tooth #9.




Close-up view of a four-and-a-half
year old composite restoration on
tooth #9 that presented with a
stained void.
Repairing a composite defect will
require roughening the composite
surface.
Use a large, round, fine-grit diamond
bur on the surface of the restoration.




The bur should only engage deep
enough to make a saucer-shaped
preparation.
A beveled margin is desired.




  If the defect extends deeper into
    the saucer-shaped preparation,
use a smaller round bur to deepen
                     only that area.
Etch the preparation to clean debris
                        and apply a thin layer of unfilled
                        resin, but do not cure at this time.




Place and sculpt the
 composite, without
over-bulking it, then
          light-cure.
Contour the repair to mimic the
natural dentition. After contouring the
repair, complete a final polish of
the restoration to achieve esthetic
and functional success.
Close-up view of the repair to correct the defects and the stained void shown below.
To receive the quarterly, peer-reviewed
    Journal of Cosmetic Dentistry,
     become an AACD member at
         www.AACD.com/join

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Repairing Composite Defects

  • 1. Techniques to Remedy Surface Defects Simple, Successful Composite Repairs Corky Willhite, DDS, FAGD, AACD Accredited Fellow Illustrations by Zach Turner
  • 2. When patients present with esthetic composite restorations requiring repair, or if defects are detected during the direct restorative process, a simple technique for repairing composite defects is invaluable. This basic technique can be varied slightly to correct composite defects at a couple of different points in the restorative process: initial placement and post-treatment. These procedures can remedy defects involving pits and voids, fractures, white lines, and improper contouring. Key to this technique’s success is ensuring that the repair is completed prior to any polishing if the procedure is to be accomplished during the initial fabrication of the restoration. If the surface has already been polished, added composite will not bond to the surface. Therefore, it will be necessary to roughen the composite surface in order to repair the composite defect.
  • 3. Additionally, for the post-treatment repair of microhybrid and nanohybrid restorations more than one day old, a micro-etching sandblast should be applied to the defective area prior to etching with 35% phosphoric acid. For microfill repairs, this author does not recommend sandblasting. Because the microfill composites contain such small and uniform particles, micro-etching decreases the mechanical retention created by the bur marks. Adapted from the full article, which originally appeared in the AACD’s Journal of Cosmetic Dentistry, Fall 2010 issue. For more information, visit www.AACD.com.
  • 4. Close-up view showing two defects on tooth #9. Close-up view of a four-and-a-half year old composite restoration on tooth #9 that presented with a stained void.
  • 5. Repairing a composite defect will require roughening the composite surface.
  • 6. Use a large, round, fine-grit diamond bur on the surface of the restoration. The bur should only engage deep enough to make a saucer-shaped preparation.
  • 7. A beveled margin is desired. If the defect extends deeper into the saucer-shaped preparation, use a smaller round bur to deepen only that area.
  • 8. Etch the preparation to clean debris and apply a thin layer of unfilled resin, but do not cure at this time. Place and sculpt the composite, without over-bulking it, then light-cure.
  • 9. Contour the repair to mimic the natural dentition. After contouring the repair, complete a final polish of the restoration to achieve esthetic and functional success.
  • 10. Close-up view of the repair to correct the defects and the stained void shown below.
  • 11. To receive the quarterly, peer-reviewed Journal of Cosmetic Dentistry, become an AACD member at www.AACD.com/join