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In recent years, multi-layer filling technology is more popular to obtain a filling effect close to that of natural teeth. However, such a technology is often cumbersome and requires a lot of resins, which is also technically challenging. This technique focuses on restoring the physiological thickness of natural teeth in layers. Among them, the restoration of enamel layer is the most important for the final aesthetic restoration effect.
In the preparation of the cavity, if the edge bevel is prepared on the lip surface and the tongue surface, 2 / 3 of the preparation should be carried out on the enamel. Enamel determines the brightness of the tooth, while dentin determines the hue and saturation of the tooth. With the increase of age, the glazes become less bright. So there should be several semi transparent resins to simulate the age factor of natural teeth. For the restoration of anterior teeth, the most important step is to restore the enamel layer. Therefore, we suggest that the lightness value should be determined before color comparison. The complete clinical procedure is described in detail in the following example. Assuming that the original filling of the incised ridge of tooth 21 is not beautiful, it needs to be restored:
The first step is to make sure that the light in the consulting room is not too strong. The focus is on the 1 / 3 of the cut end and the 1 / 3 of the middle, because the enamel of these two parts is the thickest, which is helpful to determine the color comparison of the enamel.
The second step is to determine the saturation and hue according to 1 / 3 of the neck of the tooth. (Fig. 1)
The third step is to remove the old filling body and prepare a wide hole edge slope. (Fig. 2)
The fourth step is to place the rubber barrier and the molding piece. (Fig. 3)
The fifth step is to place a layer of translucent resin material on the tongue side. It can be made of silicon rubber impression back plate or molded sheet. In order to make the color transition between the natural teeth and the filled resin natural, another layer of opaque transition color resin is filled on it. This layer of resin should not extend to the incised crest or to the gingival margin of the cavernous type (Fig. 4).
In the sixth step, the dentin layer was restored with resin close to the natural color. This layer should not be too thick. It should gradually become thinner at the cutting end, and do not block the translucency (Figure 5).
In the seventh step, a thin layer of translucent resin is used to extend to the incised ridge to simulate the hardened dentin layer (Fig. 6). It is important to note that this step leaves enough space for the final outer layer of translucent resin.
Step 8: use the same resin as the lingual side for the outermost layer. (Fig. 7)
The ninth step is to polish with a drill needle and a disc. The final effect is lifelike. (Fig. 8)
This technology only uses 4 or 5 layers of different composite resin materials, and the result is good. Therefore, this method can be used routinely in cases with four kinds of holes or incisional defects.
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