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)
Posterior Decay
A lawyer aged 37 presented an asymptomatic, discoloured tooth #14. The tooth had a large distal cavity. During examination a small carious lesion was also noticed on tooth #15. This was restored first to create proper distal contact for the tooth. Restoration of tooth #14 was more challenging since the cavity was deep and iatrogenic pulp exposure had to be prevented. Maintaining proper contact with adjacent tooth was another challenge in this case.
Figure 1
Large discoloured carious defect on tooth #14.
Figure 2
Direct cosmetic restoration placed on tooth #14.
Figure 3
Buccal view with visible discolouration on tooth #14.
Figure 4
Buccal view after cosmetic restoration.
Figure 5
Figure 6
Remove infected caries and prepare tooth #14. Note small cavity on tooth #15.
Figure 7
Restore small cavity on tooth #15 before placing the Toffelmire matrix and wedge on tooth #14.
Figure 8
Apply flowable resin (#A3O) on cavity floor to mask the discolouration after etching and bonding.
Figure 9
Note the smooth layer of flowable resin after curing.
Figure 10
Convert Class II cavity to Class I by applying enamel shade on the distal wall.
Figure 11
Remove matrix retainer and wedge for easy material placement.
Figure 12
Build-up the dentin and enamel layer incrementally to obtain natural anatomy.
Figure 13
Apply stain on the occlusal groove with an endodontic instrument.
Figure 14
Apply a thin layer of enamel (#INC) over the stain and sculpt the occlusal surface.
Figure 15.
Restored tooth #14 & #15 after finishing and polishing.
Preserving Health, Enhancing Smiles
Minimally Invasive Cosmetic Dentistry
(MiCD) is a holistic patient-centric treatment approach
