Class IV #8 and #9

Posted on March 07 2017

Before

Step 1

 Due to long standing decay the overlapped teeth have slightly collapsed into one another.

Preps

Step 2

Greater Curve "Wide" in place

Step 3

The mesial portion of the band is folding toward the prep. See next photo on how to achieve more band flare toward #9.

Optimal band flare toward #9

Step 4

I achieved more band flare toward #9 by rotating the head of the retainer toward the teeth and securing the rotatation with Triad Gel.

Band cut back

Step 5

Labial portion of band cut away for access.

Bonding agent placed

Step 6

Etch and rinse enamel, Prelude SE bonding agent, Activa A2 is incremented throughout the entire prep with the exception of the mesial labial corner. I also placed Teflon tape to better shape the mesial emergence contour.

Filtek Supreme Ultra placement

Step 7

Filtek Supreme Ultra A2 placed at the cervical and A1 completes the mesial incisal. The Filtek is overbuilt.

Initial shaping

Step 8

Initial shaping is done with the matrix left in place. Helps prevent gouging along the gingival border.

Ensuring equal width

Step 9

Used a boley gauge to insure 8&9 will be equal in width. It is important to exit your stool and get face to face with your patient. This is the only way to make certain the midline is adjusted parallel to the long axis of the patient's face.

Greater Curve "Wide" placed around #9.

Step 10

Matrix cut back

Step 11

Mesial contact opening made in the matrix.

Initial Shaping

Step 12

As done with #9, do your initial adjusting with the matrix left in place.

Final class IV's 8&9

Step 13

Very important to do your final touch up facing the patient. Don't become a victim of a 10:30 positioned parallax view. Move from your comfortable stool and directly face your patient.

Conclusion:

Activa is very strong. Bonds well to tooth and composite. It is flowable, so it is quick and easy to place. Activa is bioactive. These properities make it an excellent supporting material.

3 comments

  • Nathan Mayo DDS: March 09, 2017

    Nice work, Doc. I get similar results with EsthetX, but have been considering moving to Filtek Supreme because it supposedly polishes better. I think you and I must be cut from the same cloth. Here is an “attaboy” for you.

  • Cynthia kibiuk: March 09, 2017

    WOW….Nice job

  • Dr. John Fox: March 08, 2017

    New email : johnfoxdds@charter.net

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