Introduction
Direct esthetic restorations are tooth-coloured fillings – today almost always resin composites – built up and light-cured in the cavity in one visit. This topic covers the armamentarium and the placement technique step by step. Composite is technique-sensitive: success depends on shade, a dry field, control of shrinkage and thorough curing.
Shade selection and placement steps
Choose the shade before isolation, on clean, moist teeth, in daylight or colour-corrected light. Under rubber dam teeth dehydrate within minutes and look lighter and more opaque, so a shade picked later is too light. Look in short glances, judge value (lightness) first, and check the cervical, middle and incisal thirds.
- Clean with pumice, anaesthetise if needed, select the shade.
- Isolate, preferably with rubber dam.
- Prepare the cavity (topic 18); in a deep cavity, a liner only over the deepest part (topic 23).
- Place the matrix and wedge: band seated beyond the gingival margin, wedge inserted firmly (contours and contacts: topic 24).
- Adhesive procedure: etching, primer, bonding agent, light-curing (topic 13).
- Insert the composite in increments, adapting and curing each one.
- Remove wedge and matrix; cure again from buccal and lingual.
- Finish and polish; after removing the dam, check the occlusion.