Direct Restorations, 1st ed. 2024
Clinical Steps for Working Protocols

This book is a practical guide to direct restorative treatments, offering multiple examples of alternative techniques for the quick and predictable resolution of cases. It gives an overview of all stages of patient management including technical support, ergonomics, working technique, and workflow of the treatment stages. Up-to-date guidance is provided on tools, materials, diagnosis, and planning protocols as well as on pre-restorative procedures. Layering and morphology modelling techniques of the anterior and posterior teeth are covered in detail and methods for direct proximal wall restoration are explained. Readers will find guidance on restorative techniques for cervical lesions, injection moulding, occlusal adaptation, and the management of failures. The book is a valuable companion explaining all the stages needed to achieving good, predictable, and long-term prognostic results in an efficient manner with respect to clinical principles proven and validated by academic studies.

Preface

Dedication

PART I: Preparing the dental office and the patient for restorative treatments

Chapter 1 Equipment, ergonomics and magnification workflow

1.1 Tools and equipment

1.1.1 Dental Operating Microscope - overview and brief history

1.1.2 Minimally invasive instruments for tooth preparation

1.1.3 Instruments for direct restorations

1.1.4 Dental matrices

1.1.5 Instruments and materials for finishing and polishing

1.1.6 Lamps for light curing materials

1.2 Materials

1.2.1 Materials for pulp protection

1.2.2 Materials for long term restorations

1.3 Ergonomics of treatments. Four handed dentistry

1.3.1 Instruments transfer

1.3.2 Indirect vision (with mirror) and patient positioning

Chapter 2 Diagnosis, planning, work protocol

2.1 Anamnesis, examination, complementary investigations, diagnosis

2.2 Making and communicating a treatment plan

2.3 Direct restoration - clinical steps and working protocol

Chapter 3 Pre restorative procedures

3.1 Techniques for replicating a pre-existing morphology

3.1.1 Impression of the occlusal surface to produce an occlusal key --“Stamp technique"

3.1.2 Impression of the palatal surface of the frontals --“Palatal silicone key technique”

3.1.3 Impression of buccal and oral embrasures with liquid rubber dam and classic matrix ring

“Custom ring technique".

3.2 Deep Margin Acquisition (DMA) techniques

3.2.1 Deep margin elevation

3.2.2 Gingivectomy

3.2.3 Crown lengthening

3.2.4 Surgical Partial Extraction/ Extrusion Technique (PET)

3.2.5 Orthodontic extrusion

3.3 Rubber dam isolation

3.4 Adjacent tooth and papilla protection techniques (prewedging and wedgeguard)

3.5 Cavity design and preparation techniques

3.6 Cavity finishing and evaluation

3.6.1 Cavities checking with caries detectors

3.6.2 Cavity beveling

3.6.3 Teeth separation

3.7 Techniques for limiting and delaying the treatment

3.7.1 Pulpal protection

3.7.2 Indirect pulp capping

3.7.3 Direct pulp capping

PART II: Direct restorations

Chapter 4 Contact points. Direct proximal wall restoration using centripetal techniques

4.1 Techniques for posterior teeth using different types of materials and layering strategies

4.1.1 Oblique and split layering technique

4.1.2 Technique based on precured flowable composite on gingival edge

4.1.3 Technique based on co-cured flowable composite on gingival edge (SnowPlow)

4.1.4 Marginal ridge technique with flowable bulk and packable composite

4.1.5 Open Sandwich Technique (with GIC/ Giomers/ Flowable composite)

4.1.6 Bulk fill technique

4.1.7 Injection moulding technique

4.2 Techniques for posterior teeth using different matrices related strategies

4.2.1 Saddle matrix technique

4.2.2 Circular matrix technique

4.2.3 Single matrix technique for mirror cavities

4.2.4 Two-matrix technique for mirror cavities

4.2.5 Matrix-in-matrix technique

4.2.6 Transparent contoured celluloid matrix technique

4.3 Techniques for direct restoration of frontal teeth

4.3.1 Technique using a metal contoured sectional matrix

4.3.2 Technique using celluloid contoured sectional matrix

4.3.3 Straight celluloid tape technique

4.3.4 Free-hand modelling technique

4.3.5 Cotton roll Teflon tape technique

Chapter 5 Layering and morphology modelling techniques

5.1 Anterior teeth

5.1.1 Anatomic stratification technique (of Lorenzo Vanini) for fourth class cavities

5.1.2 Additive restoration techniques for incisal edges

5.1.3 Simplified layering technique for fourth- and third-class cavities

5.1.4 Monoshade technique

5.2 Posterior teeth

5.2.1 Successive cusp technique

5.2.2 Symmetric cusp technique

5.2.3 Simultaneous cusp technique

5.2.4 Stamp technique

5.2.6 Bilaminar technique

Chapter 6 Restorative techniques for cervical lesions

6.1 Key features of the cervical area

6.2 Isolation, cavity preparation and choice of materials

6.3 Working technique

Chapter 7 Finishing, polishing and occlusal adaptation techniques

7.1 Contour finishing and excess removal

7.2 Finishing the shape and occlusal adaptation

7.3 Surface finishing and roughness reduction

7.4 Finishing and polishing of direct restorations of anterior teeth

Chapter 8 Injection moulding - for incisal edges and direct onlays

8.1 Indications, materials

8.2 Injection moulding working protocol

8.3 Special features for anterior teeth. Palatal veneers and incisal edges

8.4 Special features for posterior teeth - direct onlays

8.5 Vailatti 3-step technique of complex restoration with increasing of VDO

Chapter 9 Indirect restorations

9.1 Tooth preparation

9.2 Immediate Dentin Sealing (IDS) and preparation optimization

9.3 Re preparation. Definitive preparation of the margins. Relocation of stress

9.4 Impression and provisional restoration

9.5 Cementation

Chapter 10 Managing failures

10.1 Decision to partially or fully replace damaged direct restorations

10.2 Failures of indirect restorations

Dr. Marius Bud is a graduate of the Faculty of Dentistry in Cluj-Napoca, Romania class of 2002. He followed a master's degree (UMF Cluj-Napoca) and in 2008 he defended his Ph.D. in medical sciences. He did research internships at the Universities of Leuven (Belgium), Amsterdam and Paris and for the last 12 years he has been working in the conservative odontology department of Cluj Napoca Dental Faculty where he coordinates the student scientific circle of restorative dentistry. Holds the lecture of direct restorations for 5th year students. He is the author and co-author of several books and articles published in international magazines. Annually, Dr. Marius Bud gives dozens of presentations and workshops on restorative dentistry (direct restorations) and digital imaging/CBCT addressed to doctors in the country but also abroad (China, Sweden, Belgium, Portugal, etc.). Dr. Marius Bud carries out his professional activity in the MB Dental Cluj-Napoca clinic, applying the concept of "microscope dentistry" also for restorative treatments (fillings, prosthetics), being one of the pioneers of performing direct restorations under microscopic control.

Offers detailed step by step working protocols with pictures for the most frequent restorative cases

Includes videos to illustrate techniques

Discusses main difficulties of restorative treatment and solutions to solve them