DTUS0610

f DT page 2A sequent layers of microhybrid mate- rial. After light curing for 20 seconds, the next step is to layer in the micro- hybrid material. First, using a unidose delivery, the first increment of microhybrid com- posite (Premise, Kerr) is placed into the proximal box of the preparation. A smooth-ended condensing instrument is used to adapt the restorative material to the inside of the sectional matrix and prepara- tion. This first increment should be no more than 2 mm thick. After light curing the first increment, the next increment should extend to the apical portion of the interproximal contact and extend across the pulpal floor. Facial and lingual increments are placed and sculpted using a Gold- stein Flexithin Mini 4 (Hu-Friedy). A #2 Keystone brush (Patterson Dental) is lightly dipped in resin and used to feather the material toward the margins and smooth the surface of the composite. Figure 8 shows the restoration after completion of the enamel layer prior to matrix band removal. The Composi-Tight Matrix For- ceps were used to remove the sec- tional matrix after removal of the flexible wedge and Soft Face 3D Ring. The Composi-Tight™ 3D Ring reduces flash to a minimum. Fin- ishing and polishing were accom- plished using Q-Finisher Carbide Finishing Burs (Komet USA). Typically, three grits and, cor- respondingly, three different burs are used to finish composite mate- rials. With the Q-Finisher system, the blue-yellow striped bur with its unique blade configuration does the work of two burs with one. An excellent surface quality on composite and natural tooth is achieved due to the cross-cut design of the cutting instrument. The small, pointed (H134Q- 014) Q-Finisher was used to make minor occlusal adjustments on the restorative surface as needed and to smooth and refine the margin- al areas of the restorative material where accessible (Fig. 9). The fine, white stripe ultra-fine finishing bur (H134UF-014) was used in the adjusted areas for precise fine finishing (Fig. 10). Komet Diamond Composite polishing points (green, polishing; and gray, high shine) were then used to polish and refine the restorative surface (Fig. 11). DENTAL TRIBUNE | March 2010 Hinman Meeting Preview 17A AD About the author Robert A. Lowe, DDS, FAGD, FICD, FADI, FACD, maintains a private prac- tice in Char- lotte, N.C. A diplomate of the Ameri- can Board of Aesthetic Dentistry, Lowe lectures internationally and is chairman of Advanstar Den- tal Media’s continuing educa- tion advisory board. He can be reached at (704) 364-4711 or at boblowedds@aol.com. The 98th Thomas P. Hinman Den- tal Meeting will take place March 25–27 in Atlanta. According to orga- nizers, the 2010 meeting is where excellence will abound. In fact, the Hinman meeting is known for its world-renowned rep- utation of excellence — bringing together the highest quality program- ming from the foremost authorities in the field of dentistry. Some of the highlights at Hinman 2010 include the following: • More than 60 leading experts in the field of dentistry will offer pre- sentations. • More than 25 percent of courses offer the opportunity for hands-on participation. • New, all-day educational tracks will be offered for dental hygienists, assistants and business office per- sonnel. • Also new this year is Art in the Hall. Hinman and The Foundation for Hospital Art will combine forces to create murals for medical facilities in need. Meeting attendees can stop by and paint for a few minutes or stay until a mural is finished. • Two hours on Saturday will be dedicated exhibit hall time, with no education held during this period. • The exhibit hall will offer cours- es for assistants and dentists, inter- active artwork and the return of the popular Hinman Eatery. The meeting also offers plenty of networking opportunities and social events. Educational opportunities This year, Hinman has designed spe- cial, full-day courses for each team member. A “Prevention Convention” for hygienists will be held on Thurs- day, a “Business Office Bonanza” and an “Assisting Extravaganza” will be Hinman offers new highlights g DT page 18A held on Friday. These special courses are offered so that each team member can get a variety of information on different topics from six of the most respected lecturers in their specific areas of expertise. In addition, there are separate speaker “tracks,” highlighting all the speakers who might be of interest to hygienists, business office staff and assistants. Each lecture is 50 minutes with a mid-day break for lunch and to visit the exhibit hall. These unique courses are offered at a special fee of $75 for the full day. A variety of lunch options are available at the Hinman Eatery in the exhibit hall. This year’s keynote session not only presents an esteemed roster of expert speakers, but also features one of Hinman’s more unique key- note speakers in recent history. Frank W. Abagnale is one of the world’s most respected authorities on the subjects of forgery, embezzle- ment and securities documents. His name might sound familiar. The movie Catch Me If You Can, starring Leonardo DiCaprio and Tom Hanks, was based on his life and book. Once polishing is complete, the final step is to place a surface seal- ant (Seal and Shine, Pulpdent) to seal and protect any microscopic imperfections at the restorative marginal interface that may be left as a result of our inability to access these areas on the micron level. Remember, an explorer can “feel” a 30-micron marginal gap at best. Bacteria are 1 micron in diameter. The purpose of the Seal and Shine is to fill these areas. Figure 12 shows an occlusal view of the completed Class II composite restoration. Conclusion A technique has been described: 1) to control proximal tissue bleeding prior to matrix placement with Expa-syl (Kerr), 2) utilize a sectional matrix sys- tem (Composi-Tight 3-D, Wedge- Wand, Garrison Dental Solutions) and a nanofilled microhybrid com- posite (Premise, Kerr) to create an anatomically precise proximal sur- face, and 3) use the Q-Finisher, two-bur composite finishing system (Komet USA) to finish then polish with dia- mond composite abrasives (Komet USA), refining marginal integrity without destroying occlusal anatom- ic form. The interproximal surface has been re-created with natural ana- tomic contour and has a predictable, elliptical contact with the adjacent tooth. With proper occlusal and proxi- mal form, this “invisible” direct composite restoration will ser- vice the patient for many years to come. DT Fig. 11: A fine-pointed diamond com- posite polisher smoothes adjusted areas during polishing. Fig. 12: An occlusal view of the direct MO composite restoration after application of Seal-n-Shine sealant.