Composite Fillings

I really enjoy the artistry involved in creating restorations made of composite. 

Placing a composite filling is incredibly intricate and technique sensitive (much more so than amalgam) involving many important steps. The final result can be VERY different in different operator hands. To be successful long term, every stage needs to be carried out meticulously.

- ISOLATION: with a close-fitting rubber dam sheet to prevent moisture ingress. Moisture is our enemy when placing composites.

- REMOVAL OF DECAY: Careful removal of tooth decay using a guard to protect the adjacent tooth if necessary.

- BONDING: A bond is used to help secure composite to the tooth. Having a good bonding protocol and carrying it out correctly is crucial.

- SHAPE: If a matrix is needed to help re-build the wall of the tooth, it needs to be well adapted and contoured correctly to ensure the composite restoration is ideally shaped.

- INCREMENTS: In a deep cavity, composite needs to be placed in increments with each layer being well cured (with a blue light)

- ANATOMY: The anatomy and form of the tooth should mimic nature and take into consideration the opposing tooth against which it is biting. When biting, forces should be balanced and distributed through the tooth correctly.

- VISION: Using magnification and having good lighting throughout is paramount.

If any of the above steps are not carried out correctly, rushed, or corners cut, it could lead to premature failure of the restoration.

Placing a successful composite involves using a highly developed skillset and having a good understanding of all the stages involved. The devil is in the details.