Page 5 - GP fall 2023

The Bioclear Method for Predictable Contacts in Adjacent Class II
Composite Restorations: A Visual Essay

Authors: Shimaa Abdelhady, BDS and Arthur Volker, DDS, MsED, FAGD, FACD

Proper proximal contact plays an important
role in maintaining the integrity of the den-
tal arch, interdental papilla, and periodontal
health. However, open proximal tooth con-
tact could permit food impaction, resulting
in subsequent dental caries, halitosis, and/or
periodontal disease. In addition, open prox-
imal contact can lead to teeth drifting and
traumatic occlusion. Therefore, it is imper-
ative that Class II restorations are complet- Figure 2. Pre-operative clinical presenta- Figure 6. Using a Bioclear Blaster and Alu-
ed with appropriate interproximal contacts. tion. A rubber dam placed with a medium minum Tri-hydroxide to remove disclosed
This can be an even more difficult under- Bioclear Diamond Wedge inserted to help biofilm. Note the extent of non-carious bio-
taking if the clinician must restore adjacent facilitate the separation of the adjacent film on the proximal surfaces of the tooth.
interproximal contacts in the same visit. teeth. Photos were taken through a CJ Optik
This article will demonstrate a step-by-step Flexion operating microscope.
protocol using the Bioclear Method.
Clinical case:
A 27-year-old male patient, without any
medical conditions, presented to the dental
office complaining of food impaction and
a space between his upper left premolars.
Clinical and radiographic examination re- Figure 7. Final preparation of the inter-
vealed two existing class II restorations proximal lesions. Note the rounded angles
with recurrent caries, one on the distal of and absence of a traditional “proximal
tooth #12 and the other on the mesial of #13. Figure 3. Initial removal of caries with ro- box” form seen in traditional Black Class
Additionally, a portion of the DO composite tary instrumentation and caries detector. II preparations.
on #13 had fractured. No signs of pulpal in-
flammation or necrosis were observed. The
two teeth responded positively to thermal
stimuli.

Figure 4. Progression of preparation and Figure 8. Using a bulk-filled flowable com-
caries removal. It is imperative to ensure posite to restore the lingual extent of the le-
that interproximal contacts are open, in- sion on #12.
cluding the pulpal floor, to ensure the place-
ment of the anatomical matrices.

Figure 9. Once the small lingual lesion was
restored, the wedge was removed, and two

Figure 1. Pre-operative radiograph demon- Figure 5. Disclosing solution placed to vi- Bioclear premolar matrices were inserted in
a back-to-back configuration. The matrix on
strating recurrent adjacent interproximal sualize biofilm. With Bioclear restorations, #12 acts as a “shepherd” to help maintain in-
caries on tooth #12 DO and #13 MO. the composite extends outside the “box” terproximal spacing but will not be filled. The
preparations and onto the buccal and lin-
gual aspects of the involved tooth. There- wedge was replaced, and a Twin-Ring sepa-
fore, it is important that these surfaces are rating ring was positioned between the teeth.
clean and free of biofilm. www.nysagd.org l Fall 2023 l GP 5