Goodbye Old Friend – A Case Study By Dr. Jure Poglajen

This clinical case involves a 55-year-old female patient who presented with a stained composite restoration on tooth #24, which exhibited secondary caries. Given the compromised nature of the restoration, it was determined that the composite needed to be removed and replaced.

A rubber dam was placed to isolate the treatment area, and a Fender Wedge (Directa) was used to protect the adjacent tooth and create sufficient space for the placement of a matrix. The Fender wedge includes a metallic shield and is particularly important for preventing damage to the neighboring tooth during preparation.

In my practice, I prefer to use purple Fender Wedges, as they are smaller and more appropriate for most clinical situations. Other wedge options, such as the orange, are also used based on specific needs. Additionally, I often use Fender Mate (Directa) as a pre-curved wedge to achieve a better anatomical shape like in the present clinical case.

Laser technology was utilized during the procedure to ensure the complete removal of any remaining caries and to prepare the surfaces for optimal bonding. After careful cleaning and debridement, the tooth was etched and bonded to prepare for the new restoration. Predicta Bulk Bioactive composite material (Parkell) was chosen for the restoration, and it was applied to fill the cavity, slightly overfilled due to oxygen inhibition layer.

The final result demonstrated excellent color adaptation. Initially, the composite material appeared more opaque and whiter compared to the natural tooth. However, once in place, the material seamlessly blended with the surrounding tooth structure, making it difficult to discern where the material begins and ends. The patient was highly satisfied with the aesthetic and functional outcome of the restoration.