Preclinics of Conservative Dental Medicine · MU Sofia
26. Direct esthetic restorations – armamentarium and placement techniques.
Covers the armamentarium for direct tooth-coloured composite fillings, shown in a table of groups, purposes and items, followed by a step-by-step placement sequence from shade selection to polishing. It explains composite shrinkage stress and the C-factor, with example values for Class I, II and IV cavities, and describes oblique incremental layering, light-curing parameters and finishing from coarse to fine. Bulk-fill composites and a list of typical mistakes are also included.
Topic 26 of 53 in the MU Sofia syllabus for Preclinics of Conservative Dental Medicine (Dental Medicine, Year 3). The free AceMed note covers it in 7 sections, about 830 words (7 min of reading), with 17 flashcards.
In this note
Introduction
Armamentarium
Shade selection and placement steps
Incremental technique and polymerisation stress
Curing, finishing and polishing
Typical mistakes
Key points
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.
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