Page 35 - DP Vol 19 No 2 HR_Neat

Fig 5: Pre ops Fig 6: Composite button technique Value – gives enamel
shade (Monochromatic image

Fig 7: Hue Fig 8: Chroma – Degree of Saturation, Gives dentin shade
(Oversaturated image)

Fig 9: Isolation, Abrasion and etching Fig 10: That’s my big reveal! No pulp exposures

match possible. The dentin is selected at the cervical area. Body at the contacts between teeth. Anterior isolation is achieved by punching
middle one third and Enamel at the incisal one third area since enamel holes on teeth to be worked on and the assembly is held in place by
is the thickest here and devoid of any dentin (in young patients). clamping the premolars. Floss ties are further used to retract the
The photograph thus clicked gives us Hue. A monochromatic image gingiva and expose the cavities sub gingivally.
of the same picture helps assess value and an oversaturated picture
gives us Chroma. Air abrasion: Aluminium trihydrate (50micron) was used to abrade
Once the Shade selection is done we can simply flick off the buttons. the surface of the enamel and dentin creating roughness that helps in
In this case, we have selected three opacities Opaque light (OL), A2 retention of resin tags- Micromechanical bond
universal and Clear translucent (CL) available from Topaz, Kulzer.
Etching protocols: Total etch technique is used in this case applying
Procedure (SteP by SteP) 37% phosphoric acid for 15-20 sec on enamel and 5-10 seconds on
Local Anaesthetic: The patient is always injected a local anaesthetic to dentin. The gel is then washed and air dried taking care to wash
make him comfortable prior to the procedure, this ensures no sudden completely and not over desiccating the tissues.
movements and most times the patient is comfortable enough to sleep
in the chair. This reduces the anxiety in the room enabling the team to Bonding protocols: 8th Generation bonding agent is used in this case
deliver better results. (Gluma, Kulzer). The content of the bonding agent is acidic monomers,
acetone and water. Acetone is a vehicle which drives out the water in the
Rubber dam: A medium sheet was chosen for this case due to the tight dentinal tubules and evaporates allowing better wettability of bonding
Dental Practice i March-April 2023 i Vol 19 No 2 35