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. Sushil Koirala (NP)
Anterior Decay
A male school teacher aged 42 presented with obvious discolouration and class III carious lesion on the central incisors (#11 & #21). Caries was detected in the lateral incisor (#12). The patient requested for direct cosmetic restorations. A labial approach was used to treat teeth #11 & #21 whereas a palatal approach was used to treat tooth #12 since the labial enamel was intact and not discoloured. Achieving invisible restorations with ideal shade match was the main clinical challenge of this case.
Figure 1
Discolouration seen on tooth #11 & #21.
Figure 2
After placing direct cosmetic restorations on tooth #11 & #21.
Figure 3
Palatal view of decay seen in tooth #11 & #21.
Figure 4
Palatal view after restoration.
Figure 5
Figure 6
Create labial access with Diamond Point #340S.
Figure 7
Remove infected dentin with spoon excavator.
Figure 8
Intact lingual frame after complete caries removal.
Figure 9
Protect tooth #11 with metal strip and selectively etch the enamel and dentin.
Figure 10
Prime the dentin and apply bonding agent on entire restorative surface.
Figure 11
Build-up entire cavity of tooth #21 with enamel layer (#INC).
Figure 12
Finish the restored surface of tooth #21 with Dura White Stone #CN1.
Figure 13
Finish and polish with OneGloss Midi Point.
Figure 14
Isolate tooth #21 with polyethylene based plumbing tape, before etching and bonding tooth #11.
Figure 15
Build-up first dentin layer (#A3) using free hand technique.
Figure 16
Build-up second dentin layer (#A2).
Figure 17
Build-up enamel layer (#INC).
Figure 18
Smoothen enamel layer with a brush.
Figure 19
Protect the adjacent tooth with a metal strip and finish restoration with Diamond Point #SF215.
Figure 20
Finish mesio-incisal angle with a a safe sided Super-Snap finishing disk.
Figure 21
Interproximal polishing with Super-Snap Polystrip.
Figure 22
Dispense diamond polishing paste on tooth #11 & #21.
Figure 23
Super polish with buff disk to achieve a high shine.
Figure 24
Restored tooth #11 & #21 with high surface gloss.
Figure 25
Palatal view of restored teeth.
Preserving Health, Enhancing Smiles
Minimally Invasive Cosmetic Dentistry
(MiCD) is a holistic patient-centric treatment approach
