Dental Sealant, Preventive Resin Restoration, & Class I Composite Restoration / 3

When caries has penetrated to the DEJ and beyond, a Class I preparation and restoration are indicated.  Two direct dental restorative materials may be used to restore such an area: amalgam and composite resin.  When cosmetic issues outweigh functional (resistance form) issues, composite resin may be preferred.  Also, composite resin may be indicated for patients with mercury phobia or metallic allergies.  However, potential allergies or side effects from resin components are issues that should also be discussed with patients.

The occlusal preparation for composite resin is identical to one prepared for amalgam.  It must extend just beyond the DEJ to determine the full extent of carious involvement.  Mesial and distal walls diverge for resistance form; buccal and lingual walls converge for retention form. Convenience form must allow for insertion of the resin. Bevels are NOT placed on the cavosurface margins; butt joint margins will provide better edge strength for occlusal function.

The restoration begins with etching, rinsing, and light drying of the preparation, keeping the dentin moist. Optibond Solo Plus is applied, air thinned, and cured.  Increments of less than 2 mm are condensed and shaped, then cured for 40 seconds each.  At the cavosurface, carefully condense anatomy into place prior to curing.  Finish and polish the restoration.  Adjust the occlusion.  OptiGuard may be used as a surface sealant if desired.