Chairside Anterior Build-up Simplified With Aura Ultra Universal Restorative

Les Rykiss, DMD

Though sometimes a restorative case may not be extensive, the meaning behind the smile is what is most gratifying. This 16-year-old patient had undergone orthodontics to correct rotations and crowding, and the clinician's task was simply to build-up a "peg-shaped" unesthetic lateral incisor (No. 10) that the patient had always disliked and which made her reluctant to smile. Aura Ultra Universal Restorative (SDI, sdi.com.au) was chosen as the restorative material because it is simple to use and match existing tooth structure with. Build-up with Aura is done in two layers: a nanohybrid dentin layer, and a microfilled enamel layer. The shades were selected for the dentin and enamel, the old composite was removed, and a minor tooth preparation was done. Super Etch (SDI) was used to etch tooth No. 10, followed by rinsing and bonding with Riva Bond LC (SDI). DC2 dentin shade was added, creating a dentin shelf directly to the unetched, unbonded adjacent teeth to form a thick dentin layer, and the build-up was finished with a thin layer of enamel shade E2. After trimming, contouring, and polishing, the final restoration had a beautiful, lifelike luster. The young patient was entirely pleased with the result, and her final smile was most gratifying for the clinician.

Ease of use-Aura Ultra Universal Restorative is quite simple to use in a layering technique, as it requires only a two-step layering process. Shade matching is also easy, and handling of the material is spectacular in that it is highly sculptable.

Beautiful polishability-The esthetics are superb due in part to the material's polishablity, as the enamel layer is a microfill composite. Overall strength is uncompromised because the bulk of the restoration consists of the nanohybrid dentin layer.

Extremely high wear resistance and color stability-The material wears very naturally in the mouth due to its high strength and flexibility. The color remains stable over the years with high resistance to plucking of the filler particles.

Les Rykiss, DMD
Private Practice
Winnipeg, Manitoba
Diplomate
American Board of Aesthetic Dentistry

Figures and Images

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Figure 1

Fig 1. Tooth No. 10 presented with an older, discolored, composite build-up.

Figure 2

Fig 2. Dentin shade selection was matched to the gingival one-third of tooth No. 9 with DC2 shade.

Figure 3

Fig 3. Enamel shade selection was matched to the incisal one-third of tooth No. 9 with E2 shade.

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Fig 4. Old composite was stripped off of tooth No. 10, and very minor smoothing was done as a preparation.

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Fig 5. Protection of adjacent teeth and isolation of tooth No. 10 was accomplished using Teflon® tape. No. 10 was then etched with Super Etch, a 37% phosphoric acid, rinsed, and bonded with Riva Bond LC for the final layering of composite.

Figure 6

Fig 6. After removal of the Teflon tape, a “Buddy Mopper” lingual dentin shelf build-up was created using Aura DC2 composite, building up the proximal contacts directly to the proximal walls of teeth Nos. 9 and 11, which were free of bonding agent.

Figure 7

Fig 7. A very thin layer of Aura E2 enamel microfilled composite was added over the dentin build-up.

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Fig 8. Immediately postoperative photographs showed the final result after composite trimming and polishing. A #12 scalpel was used to trim the gingival margin, and rotary high-speed trimming burs as well as low-speed wheels, points, and disks were used to contour the restoration and create the final luster

Figure 9

Fig 9. Immediately postoperative photographs showed the final result after composite trimming and polishing. A #12 scalpel was used to trim the gingival margin, and rotary high-speed trimming burs as well as low-speed wheels, points, and disks were used to contour the restoration and create the final luster

Figure 10

Fig 10. Final photographs at 1-week postoperative showed the anterior build-up on tooth No. 10 completed with Aura Ultra Universal Restorative material.

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Fig 11. Final photographs at 1-week postoperative showed the anterior build-up on tooth No. 10 completed with Aura Ultra Universal Restorative material.

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Fig 12. At 1-week postoperative, the patient had the smile that both she and the clinician were hoping for, demonstrating excellent color match and beautiful esthetics.