A straight razor blade was used to cut down the midline of the putty index which will allow a clear mylar strip to fit. In this case a diagnostic wax up and silicone putty index was fabricated to help guide the layering process and make it more predictable for composite adaptation and establishing the midline. Bonding resin (Tokuyama Universal Bond, Tokuyama Dental America) was then applied and air dried. Notice that the air abrasion and the acid etch was placed well beyond the estimated final margin which will allow for a seamless margin when finishing and polishing the composite. Phosphoric acid etch was then placed for 15 seconds and rinsed with water. Isolation is important so the Optragate retractor (Ivoclar Vivadent) was used to keep the lips out of the way and provide better visibility. Gingival retraction cord was then gently positioned along the mesial aspect of the central incisors and air abrasion (Microetcher II, Danville) was then used to microetch the enamel where the composite will be added. Tooth preparation consisted of using a prophy cup polisher and pumice to remove any surface plaque. So having the ability to place a direct restoration and know that it will still blend in seamlessly over the years is very comforting. With a standard composite, a shade is selected that matches closest to the existing tooth structure and it won’t change over time. The patient asked if she were to whiten her teeth later on would the composite still match? I let her know that the new composite that I was going to use on her will always match the color of her teeth, even if they darken over time, or if she whitens later on. She elected not to do Invisalign to close the space and instead do direct composite bonding. In this case, the patient had orthodontics in her youth and over the years stopped wearing her retainer and a diastema developed between teeth 8 and 9. In this article I would like to share techniques that have simplified how I restore diastemas.

Tokuyama’s OMNICHROMA and OMNICHROMA Blocker have been a wonderful addition to my daily restorative armamentarium and made it much easier to predictably place direct composite restorations in all areas of the mouth.

Silicone Putty Indexes for Seamless, Flawless Results: Part I Kevin Brown, Bellevue, WA, & Michelle Chan Technique Article:

Silicone putty