MiCD Clinical Techniques
Discover BioLogically Beautiful Restorations
MiCD GN aims to provide educational resources to help dentists embrace the MiCD concept and treatment protocols in routine clinical practice.
Case prepared by Dr. Amit Gulati (IN)
Minimally Invasive Multiple Diastema Closure in Lower Anteriors
45 year old male patient presented with generalized spacing between lower anteriors and requested for conservative treatment to restore aesthetics in lower front teeth. After evaluating various treatment options decision was made to proceed with direct composite restorations adopting the MiCD approach . Beautifil II range of bioactive composites were selected as the restorative material of choice followed by comprehensive finishing and polishing protocol to help achieve the desired aesthetic outcome. Direct composite resins today provide predictable & minimally invasive treatment options in clinical situations like these where other treatment options like indirect restorations and orthodontics may not be suitable due to age, time and cost related factors.
Figure 1
Pre-operative view of multiple diastema in lower anterior teeth.
Figure 2
Shade selection with VITA classical shade guide. Beautifil II shade A2 was selected for dentin layer and Beautifil II Enamel T shade was selected for the enamel layer.
Figure 3
Rubber Dam Isolation & polishing with pumice slurry. Rubber dam margins were everted for seal.
Figure 4
Super-Snap Violet disk was used for minimal enamel preparation and to create bevels.
Figure 5
Restorative surface was acid etched using 37% buffered phosphoric acid.
Figure 6
Application of 7th Generation Single component BEAUTIBOND adhesive.
Figure 7
Freehand preparation of Lingual shell with Beautufil II Enamel-T.
Figure 8
Proximal contour created with Beautufil II A2 dentin shade & gently flushed over the long bevels. Light cure for 20 seconds.
Figure 9
Beautifil II Enamel-T added as the final layer & blended using synthetic brush. Light cure for 20 seconds.
Figure 10
Teflon matrix was adapted to separate the proximal surface of adjacent teeth. Similar free hand layering protocol was followed for tooth #31.
Figure 11
Completed Dentin & Enamel free-hand layering with composite on teeth #41 & #31.
Figure 12
Similar restorative protocol was used for #42 & #32 to close all three diastemas.
Figure 13
Application of a transparent water based gel on each tooth surface and light cured for 20 seconds to remoeve the oxygen inhibited layer.
Figure 14
Gross finishing with fine (red) diamond point on facial surfaces & super-fine (yellow) in cervical areas to remove any overhangs
Figure 15
#12 Surgical blade used to contour and finish the embrasure areas and a Super snap Poly strip used to finish the interproximal surfaces.
Figure 16
After gross finishing was completed.
Figure 17
Recall visit after 2 days for final finishing & polishing procedure.
Figure 18
Anatmincal countouring achieved with Super-Snap Black disk.
Figure 19
Fine finishing with Super-Snap Violet disks.
Figure 20Interproximal finishing and polishing with Super-Snap Fine & Super fine Polystrips.
Figure 21
One Gloss Midi-points & Inverted Cone used to mimic natural surface texture & pre-polishing.
Figure 22
After fine-finishing & pre-polishing with OneGloss.
Figure 23
Final enamel like luster achieved using an alumina-oxide impregnated Super-Buff disk.
Figure 24
Immediate post operative view of final restorations.
Figure 25
Natural life-like aeestetics achieved using the Beautifil II range of direct composite restoratives with visible gingival healing.
Preserving Health, Enhancing Smiles
Minimally Invasive Cosmetic Dentistry
(MiCD) is a holistic patient-centric treatment approach
