| REPLACEMENT
DENTISTRY |
figure1 |
There
are two old restorations on the labial of the upper right
central and lateral incisors. They have already been repaired
and lost their full aesthetic appearance. They will be replaced
with glass-ionomer. |
 figure2 |
Under
rubber dam the old restorations were removed and replaced
with glass-ionomer. |
 figure3 |
Following
removal of the matrices it was decided that the colour match
of the lateral incisor was not satisfactory so it will be
laminated with composite resin. |
 figure4 |
The
restoration in the central is well sealed with a light activated
resin bond so the glass-ionomer in the lateral is gently
cut
back to allow a laminate of composite resin to be placed
over it. The cement and the surrounding
enamel is etched with 37% orthophosphoric acid for 15 seconds
then washed thoroughly
and dried lightly. |
 figure5 |
The
lamination has just been completed and the rubber dam removed.
The aesthetic end result appears to be satisfactory for both
restorations. |
 figure6 |
The
same restorations photographed 5 years after placement. There
is little difference in the aesthetic end result between the
two materials. |
| RAMPANT
CARIES |
 figure1 |
This
patient has an extremely high caries rate and the primary
object is to raise his dental profile so that he will regain
pride in his dentition and begin to take care of his teeth
again. Along with education, oral hygiene instruction and
topical applications the extreme lesions were restored with
glass-ionomer as long term provisional restorations. |
 figure2 |
The
gross infected dentine has been removed and a margin of clean
dentine developed around the full circumference of each
lesion.
There remains some demineralised affected dentine over the
area of the pulp chamber and this is expected to remineralise
under the influence of the glass-ionomer |
 figure3 |
The
completed restorations one week after placement. The aesthetic
result is satisfactory, at least in the short term, but the
patient still has work to do on the quality of the oral hygiene
technique. The option remains for the restorations to be laminated
with composite resin later when the caries rate is under control. |
