Restorative Technique – Class III

Step-by-step Class III Restoration

This PDF download by Dr. Buddy Mopper provides the pictorial steps involved in a Class III restoration from preparation to final polish. In this case, there is a carious lesion on the proximal surfaces of the canine.

Preparing the tooth for a Class III Restoration

The first set of steps involves the preparation of the tooth, including etching and bonding. Begin by preparing the tooth using a 330 Carbide bur. Next clean the interproximal contact with Cosmedent’s FlexiDiamond Strip. You then clean the interproximal contact with Cosmedent’s FlexiDiamond Strip. After cleaning, create a uniform 2mm long bevel with the 6862-012 diamond bur. Then apply Cosmedent’s EnamelEtch well past the long bevel using the #1 Brush. In final preparation step, apply the bonding adhesive, Cosmedent Complete.

Class III

Begin preparation using a 330 Carbide bur.

Clean the interproximal contact with Cosmedent’s FlexiDiamond Strip.

Create a long bevel with 6862-012 diamond bur.

Notice the uniform 2mm long bevel.

Apply Cosmedent’s EnamelEtch well past the long bevel using the #1 brush.

Bonding adhesive in place (Cosmedent Complete.)

Dentin Replacement

The steps walk you through the placement of the substructure of the tooth with either a Microhybrid or Nanofill composite. This dentin replacement, in this case, Renamel Microhybrid A3, is used as a base for its strength. It will also increase value and opaque the darkened area of the tooth. Using the Cosmedent 8AL instrument, sculpt the Renamel Microhybrid to the leading edge of the long bevel. Polymerize the Microhybrid.

Place Renamel Microhybrid A3 to increase value and opaque darkened area.

Sculpting of Renamel Microhybrid with Cosmedent’s 8AL to the leading edge of the long bevel.

Enamel Replacement

The Renamel Microfill layer is added next to simulate the enamel surface of the tooth structure. Take a small amount of Microfill in your fingers and roll it into a convenience form. This makes it easy to place on the tooth. Place the Renamel Microfill layer using Cosmedent’s 8AL instrument. Polymerize this final layer for 60 seconds.

Renamel Microfill A3 rolled into a convenience form

Place Renamel Microfill layer using Cosmedent’s 8AL instrument.

Finishing and Polishing the Composite Restoration

The final steps finish and polish the restoration. Add initial contour to the restoration with an ET9 carbide bur. When contouring, move the bur from composite to tooth. Next, using a series of aluminum oxide discs, you will continue to refine and then polish the Class III restoration. Cosmedent offers the FlexiDisc System (Mini Center) with four different girts — Coarse, Medium, Fine and Superfine. After using the ET9 bur, you will use the Coarse FlexiDisc to blend the Microfill margin into the tooth. You will then follow up with the 3/8″ Medium FlexiDics to finish at the cervical. Additionally, contour the restoration starting from the proximal to create perfect embrasures with the 5/8″ Medium FlexiDisc. To start the initial polish, use the 5/8″ Fine FlexiDisc.

Before the final polish, retract gingival tissue and reduce excess flash with the 8392-016 bur. Using the 8A instrument to torque between the two teeth, gently separate the teeth with the FlexiDimond Strip. Run a Fine/Superfine FlexiStrip in the interproximal.

To finish the composite restoration, add a dab of Enamelize Polishing Paste and polish with a FlexiBuff disc.

Contour restoration using the ET9 carbide bur (moving from composite to tooth.)

FlexiDisc Coarse – blend the Microfill margin into the tooth.

FlexiDisc Medium 3/8″ – finish at the cervical.

FlexiDisc Medium 5/8″ – contour starting from the proximal to create perfect embrasures

FlexiDisc Fine 5/8″

Retract gingival tissue and reduce excess flash with the 8392-016 bur.

Use the 8A instrument to torque the teeth and gently separate
using FlexiDimond Strip

Fine/Super Fine FlexiStrip

Final polish with Enamelize and FlexiBuff disc.

Final Restoration

About the AuthorDr. Bud Mopper

Dr. Bud Mopper has built an international reputation for his pioneer leadership in direct resin bonding.  He practiced minimally invasive dentistry with composite for over 45 years. He is a renowned lecturer in esthetic dentistry. He co-authored, A Complete Guide to Dental Bonding, which was the first definitive book for the dental profession describing bonding techniques – and he has continued to publish numerous articles on The Art and Science of Direct Resin Bonding.  He is a Life Fellow of the Academy of Esthetic Dentistry, Founding Member and Fellow of the American Academy of Cosmetic Dentistry, Life Fellow and Diplomat of the American Board of Pediatric Dentistry, and Fellow of the American College of Dentistry.  He teaches direct resin bonding on a Continuing Education level at many universities including the Iowa State University and the University of Illinois Chicago, plus he teaches courses at the Center for Esthetic Excellence.

Dr. Mopper is the recipient of three of the most prestigious awards given by the American Academy of Cosmetic Dentistry. One for “Lifelong Commitment to Providing Excellence in Continuing Education in Cosmetic Dentistry” and secondly, an award for “Outstanding Contribution to Cosmetic Dentistry” and third for “Outstanding Innovation in Cosmetic Dentistry.” He received the New York University College of Dentistry “The Irwin Smigel Prize in Esthetic Dentistry” and the “Lifetime Achievement Award” from the World Aesthetic Congress in England, for “Outstanding Contribution to Cosmetic Dentistry.” He received the 2017 Gordon J. Christensen Lecture Recognition Award from the Chicago Dental Society. Dr. Mopper was awarded the 2018 Distinguished Alumnus Award from the University of Illinois at Chicago. He is Co-founder and Chairman of Cosmedent, Inc., where he is responsible for educational programs, and product development.