Mark I. Malterud, DDS
The more trauma a tooth endures, the greater the possibility of creating tooth damage and pulpal changes. Often, doing as little as possible to restore a tooth is the kindest procedure. This case presentation represents a conservative, minimally invasive approach to restoring a previously restored segment of a dental quadrant. The patient presented with two restorations that had been placed as extraorally fabricated bonded composite restorations about 20 years previously and had now outlived their serviceable protective life. Tooth No. 19 had occlusal wear with dentin exposure on the mesial-buccal cusp. Tooth No. 20, with the old resin washed out, was undercontoured such that the tooth was functionally compromised and food was being entrapped both occlusally and laterally at the gingival level. Featuring the use of Mosaic® universal nanohybrid composite (Ultradent Products, Inc., ultradent.com), the conservative treatment rendered with direct composite restoration replacement and repair was accomplished with little additional lifetime trauma to the teeth, and it stabilized the patient’s dentition for the future with the potential to match the initial life of the original restorations.
• With advances in material sciences and restorative techniques occurring virtually daily, clinicians need to consider new paradigms.
• A conservative approach to restoration can minimize trauma and help teeth last longer before any further restoration is needed.
• With the right combination of new and existing materials, establishment of proper form, function, and esthetics can be accomplished for re-restorations, limiting added stress to the dentition.
Mark I. Malterud, DDS
Past President
Minnesota Academy of General Dentistry;
Private Practice
St. Paul, Minnesota
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