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CDE0211

I 33 industry report _ compobonds I cosmeticdentistry 2_2011 _Clinical applications of Vertise Flow The clinical uses of Vertise Flow are not unlike those of conventional flowables, but with the added advantage of eliminating the bonding stage. Below are some suggested applications. Fissuresealing One of the fundamental treatments for preventa- tivedentistryisfissuresealingofposteriorpermanent teethsoonaftertheireruptionintotheoralcavity.Tra- ditionally, this has been achieved solely with enamel etching, relying on micromechanical retention, and depending on diet, the fissure sealants require peri- odicreplacementorrepair.UsingVertiseFlowinstead of conventional fissure sealants offers not only mi- cromechanical retention, but also chemical adhesion to the enamel via the SE agent that links with the calcium ions from the hydroxyapatite matrix. The following case reports on fissure sealing of a first permanent molar tooth in a 14-year-old child. Ideally, the tooth should be isolated with a rubber damtoensuremoisturecontrolandaclearoperating field (Fig. 11). Initially, the tooth was air abraded with aluminium-oxide powder to clean the pits and fis- sures,removetheplaquebiofilm,superficialincipient decayand,ifpresent,remnantsofoldfissuresealants (Fig. 12). The cleansing was continued with a slurry of pumice to eliminate residues of the aluminium powder (Figs. 13 & 14). After rinsing off the pumice (Fig. 15), 37 % phosphoric acid was dispensed to etch the pits and fissures (Fig. 16a) and surrounding uncut,aprismaticenamel(Fig.16b).Theclassicfrosty etched enamel appearance was clearly visible after rinsing off the etchant and drying the occlusal sur- face (Fig. 17). Since Vertise Flow should be refrigerated to ensure extended shelf life and optimal performance, it is advisable to remove it beforehand to so that the material reaches room temperature. The Translucent shade of Vertise Flow was dispensed generously (Figs.18a&b)andbrushedontotheenameltoensure intimatecontactwithitssurface,andspreadtoathin layer of less than 0.5 mm (Figs. 19a & b). The coated surface(s) were light cured for 20 seconds with a curing light with an output of 800 MW/cm2 (Fig. 20). The rubber dam was then removed and articulation paper placed to check occlusal contacts (Fig. 21). All the articulation paper marks, except those on the supporting buccal cusps (palatal cusps for maxillary teeth), were adjusted and polished with Opti1Step Polisher (KerrHawe SA; Figs. 22 & 23). Small,non-stress-bearing,non-contactingcavities Smallcavitiesinareasofminimumocclusalstress are ideal candidates for minimally invasive, micro- dentistry.Incipientcariouslesionseithercanbemon- itoredifthepatientriskfactorsarelowormayrequire interventionforpatientswithapropensityfordental decay.Inthiscase,a13-year-oldfemalepatient,who is an occasional attendee and relatively indifferent to dental treatment, was treated. The preoperative status shows the maxillary second pre-molar and first molar with occlusal cav- itations, and an old defective composite occlusal restoration in the molar (Fig. 24). Cavity preparation wascarriedoutusingsmalldiamondbursspecifically Fig. 34_Pre-op view showing defective amalgam fillings in two mandibular molars. Pre-op occlusal contacts are identified before placing the rubber dam. Fig. 35_The old amalgam restorations are removed. Fig. 36_After removing soft decayed dentine, the enamel margins are finished with a 90° cavo-surface angle and etched with phosphoric acid for 15 seconds. Fig. 37_The etched enamel peripheries are clearly visible on the second mandibular molar. Fig. 38_The etched enamel peripheries are clearly visible on the third mandibular molar. Fig. 39_Vertise Flow is dispensed into the cavity. Fig. 35 Fig. 36Fig. 34 Fig. 38 Fig. 39Fig. 37