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Aesthetic dentistry section

Fig 10: Value based assessment
Finishing and Polishing: Mechanical polishing further integrates the
restoration seamlessly into the tooth structure and gives the restoration
a life like appearance. Primary and secondary characteristics are
created and micro texture is done at this stage using diamond burs,
carbide burs and periobur in some areas. Silicon points, Soflex discs,
diamond impregnated discs are some good polishing systems that can
Fig 9: Comparison deliver a well-polished restoration. Interdental areas are finished and
polished using #12 blade and interproximal strips. Final lustre is given
etch technique with 37% phosphoric acid gel. using Lucida polishing paste and buff (Diashine).
Using dental adhesive: Dental adhesives have evolved over the years Postoperative instructions and oral hygiene instructions are
making them more predictable and easier to use. It is important to explained and the patient is recalled after a week for final assessment
follow the manufacturer’s instructions based on acidity and pH of the of shape, shade, texture and marginal integration. It is quite possible
dental adhesive and the medium or vehicle (acetone or alcohol and that the finished restoration looks “off” on the day it is finished but
water) since that determines their usage, number of applications and rehydration and reassessment should be done only after a week to get
other technical factors. In this case I have used Gluma bond universal a realistic idea of the post operative situation.
(Kulzer) with a Ph of 1.6 – 1.8. Oil free air from either a 3 way or a chip
blower can be used to remove excess after the bonding agent has been CONCLUSiON
allowed to sit for some time enabling penetration into the dentinal The future of restorative dentistry is bright with the current lifestyle,
tubules making the hydrophobic tubules hydrophilic and conducive diet and aesthetic awareness of the patients. Advancements in material
to accept the restorative material. It is important to be mindful about science are leading to stronger, more durable and aesthetically
following the recommended time for etching and bonding to prevent pleasing solutions for patients. Composites are more wear resistant,
over desiccation and dead space resulting in post-operative pain and colour stable and biocompatible making them excellent restorative
discomfort (hydrodynamic theory). options in different clinical scenarios. With further developments,
Technique: A silicon putty index is used to define the palatal these materials will take centre stage when restorative dentistry is
silhouette of the tooth. The index is scribed using a sharp instrument concerned, minimizing the risk of postoperative discomfort and
and CL (Clear translucent) is placed. The teeth are translucent and ensuring durable long term solutions. n
this approach can be used for a young patient who have incisal
characterizations and translucency. The proximal walls are created in ABoUt the AUthor
enamel shade using a sectional matrix inserted into the sulcus. The
body/universal shade is placed in a mamelon pattern (A2) and tints Dr. Sanah Sayed is a Cosmetic Dentist
are placed to create the incisal halo, white diffuse intensives, amber practicing in Pune. She has completed
characterizations and translucency. This is finally layered with clear her BDS from D.Y. Patil Dental College
translucent (CL) enamel shade not exceeding 0.5 to 0.75 mm. (Navi Mumbai) and Advanced Esthetics
Removal of Oxygen Inhibition Zone: Not all monomers convert into from Manipal Dental College. She has
won various prestigious awards such
polymers and though this is a desirable quality of composites when as the “Aesthetic Practice of the Year”
layering, ensuring that the previously placed composite bonds to the at the Famdent Awards 2024. Prior to
next layer, it is a problem for the top layers exposed to the oral cavity. this, she won the “Outstanding Dentist
If a free monomer interacts with pigments in food, the restoration of the Year” in 2022, and also received
could discolor and result in an aesthetic failure. This can be resolved the accolade of “Aesthetic Dentist of
by using glycerine (KY Jelly – Johnson and Johnson) and curing for the Year” at the Dental Diva Awards in
40-60 seconds. the same year.

24 Dental Practice i March-April 2024 i Vol 20 No 2