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to not create air bubbles (Figure 8). The Conclusion to treat gingival recession associated with
flowable composite was not cured. Using The treatment of cervical lesions is subject non-carious cervical lesions. Braz Oral
a composite heater (Compex, Ad-Dent, to many clinical variables. A multi-disci- Res. 2021 Sep 24;35(Supp 2):e096.
plinary approach is often optimal, espe- 9. Gladys S, Van Meerbeek B, Lambrechts
cially in cases of gingival recession. The P, Vanherle G. Evaluation of esthetic pa-
use of a flowable opaquer with microfilled rameters of resin-modified glass-ionomer
composite seems an excellent material to materials and a polyacid-modified res-
restore missing tooth structure either as a in composite in Class V cervical lesions.
stand-alone treatment or in conjunction Quintessence Int. 1999 Sep;30(9):607-14.
with periodontal therapy. 10. Isler SC, Ozcan G, Ozcan M, Omurlu
H. Clinical evaluation of combined surgi-
References: cal/ restorative treatment of gingival reces-
1. Bartlett DW, Shah P. A critical review of sion-type defects using different restorative
Figure 8. Placement of heated flowable composite.
non-carious cervical (wear) lesions and the materials: A randomized clinical trial. J
Danbury, CT), an A2 shade of microfilled role of abfraction, erosion, and abrasion. J Dent Sci. 2018 Mar;13(1):20-29.
composite (Renamel Mircrofill, Cosme- Dent Res. 2006 Apr;85(4):306-12. 11. Poggio C, Ceci M, Beltrami R, Mirando
dent) was injected into the uncured flow- 2. Shellis RP, Addy M. The interactions M, Wassim J, Colombo M. Color stability
able composite (Figure 9). The composite between attrition, abrasion and erosion in of esthetic restorative materials: a spec-
was adapted to the tooth with a condensing tooth wear. Monogr Oral Sci. 2014;25:32- trophotometric analysis. Acta Biomater
instrument (Optra-sculpt, Ivoclar, Amherst, 45. Odontol Scand. 2016 Aug 10;2(1):95-101.
NY) and cured. (Figure 10). 3. Bernhardt O, Gesch D, Schwahn C, et 12. Kaur S, Makkar S, Kumar R, Pasri-
al. Epidemiological evaluation of the mul- cha S, Gupta P. Comparative evaluation of
tifactorial aetiology of abfractions. J Oral surface properties of enamel and different
Rehabil 2006;33:17–25. esthetic restorative materials under erosive
4. Peumans, M., Politano, G., & Van Meer- and abrasive challenges: An in vitro study.
beek, B. (2020). Treatment of noncarious Indian J Dent. 2015 Oct-Dec;6(4):172-80.
cervical lesions: when, why, and how. The 13. Battancs E, Fráter M, Sáry T, Gál E,
International Journal of Esthetic Dentist- Braunitzer G, Szabó P B, Garoushi S. Frac-
ry, 15(1), 16–42. ture Behavior and Integrity of Different
5. Pini-Prato G, Franceschi D, Cairo F, Nieri Direct Restorative Materials to Restore
M, Rotundo R. Classification of dental sur- Noncarious Cervical Lesions. Polymers
Figure 9. Placement of heated paste composite. face defects in areas of gingival recession. J (Basel). 2021 Nov 29;13(23):4170.
Periodontol. 2010 Jun;81(6):885-90. 14. Amaya-Pajares SP, Koi K, Watanabe H,
6. Cairo F, Pagliaro U, Nieri M. Treatment da Costa JB, Ferracane JL. Development
of gingival recession with coronally ad- and maintenance of surface gloss of dental
vanced flap procedures: a systematic re- composites after polishing and brushing:
view. J Clin Periodontol. 2008 Sep;35(8 Review of the literature. J Esthet Restor
Suppl):136-62. Dent. 2022 Jan;34(1):15-41.
7. Reis MBL, Mandetta CMR, Dantas
CDF, Marañón-Vásquez G, Taba M Jr, de Dr. Arthur Volker
Souza SLS, Messora MR, Bulle DBP, No- graduated from the
vaes AB Jr. Root coverage of gingival re- Columbia University
Figure 10. Adapting heated composite to the cessions with non-carious cervical lesions:
tooth. a controlled clinical trial. Clin Oral Inves- School of Dental and
Oral
Dr.
Surgery.
This technique results in excess at the buc- tig. 2020 Dec;24(12):4583-4589. Volker has published
cal region that is easily removed by a large 8. Santamaria MP, Mathias-Santamaria articles and lectures
tapered diamond (Figure 11). Figure 12 IF, Ferraz LFF, Casarin RCV, Romito GA, nationally and internationally on such
demonstrates the final result after finishing Sallum EA, Pini-Prato GP, Casati MZ. topics as cosmetic dentistry, minimally
and polishing. Rethinking the decision-making process invasive dentistry, and dental
materials. He practices at Dent-Care
Dental in Sunnyside, New York.

Dr. Soleymani graduat-
ed from the Columbia
University College of
Dental Medicine. He
practices at Dent-Care
Dental in Sunnyside,
Figure 11. Removing cervical excess with a Figure 12. Post-op frontal view. New York.
large tapered diamond bur.

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