CASE PRESENTATION,
As dentists in a general practice, most of our daily caseload involves cutting into teeth and then filling the holes that we’ve cut. Many of us simply don’t have a lot of day-to-day experience or confidence when it comes to more conservative, esthetic composite additions to teeth, especially in the anterior. As a result, rather than spending hours trying to create a desired outcome with composite—something that requires a degree of artistry and a great deal of practice—we often pursue other options that may be more invasive, such as reducing healthy enamel for ceramic restorations. However, additive composite treatment in the anterior no longer needs to be tedious, time-consuming, or unpredictable.
A new restorative solution, the 3M Filtek Matrix provides a digital design for predictable results, reduces chair time, and simplifies the procedure, creating a cost-attractive solution for the patient. The procedure accommodates straightforward to complex cases, including peg laterals, undersized or misaligned teeth, worn dentition, single/multiple diastema closures, and full maxillary cases.
Case 1: Composite Restoration—15 Years Later
A case in point is a recent patient who returned to me 15 years after a previous composite closure of a diastema between teeth Nos. 8 and 9. The composite had worn down and was in need of replacement. For me, this would be a case that may have taken 3 or 4 hours to complete, which is a very inefficient use of my time. Even when finished, I may not be completely satisfied with the outcome, because I don’t have a great deal of experience with such cases. Instead, by using the 3M Filtek Matrix, I could achieve the desired outcome in a conservative treatment without the stress of free-hand shaping.
Once we decided on the composite restorative treatment, we took an intraoral scan with a bite record and a simple series of photographs. We then uploaded this information to the 3M Oral Care Portal and received a digital design of the restoration. After approving the design, we received the 3M Filtek Matrix, which is a high-quality, 3D-printed matrix that has the digital design built into it and overlays the patient’s teeth.
When the patient returned for treatment, we cleaned, air-abraded, etched, and applied a bonding agent to hybridize teeth before placing the matrix over them. I then injected 3M Filtek Supreme Ultra Universal Restorative into the matrix and closed its doors, allowing compression of the composite against the teeth. I then cured the material through the matrix. Following polymerization, I removed the matrix and finished and polished the restoration.
The patient was thrilled—his anterior teeth look even better than they did the first time we performed the composite restoration all those years ago. And one of the best parts is that I didn’t have to prep his teeth then or now. I added composite to the teeth 15 years ago and, after he wore it down, I was able to restore again without reducing tooth structure. It’s a very conservative treatment compared to other modalities.
Case 2: Smile Makeover with 3M Filtek Matrix
This patient never really liked the shape of her teeth or the diastema, and she wanted to talk about conservative options for repairing or altering her anterior. We decided on composite veneers for Nos. 7-10. This kind of situation is tailor-made for 3M Filtek Matrix, because in a relatively short time, I can close the diastema while reshaping the undersized teeth and achieving the patient’s desirable shade. The nice thing about the matrix is that, when you compress the material on the teeth, you really get a very nice integration with the composite and the teeth.
The patient was ecstatic about the outcome and thrilled about being able to receive that makeover in a very conservative fashion. We didn’t cut the teeth down at all—there is no prepping. It’s done directly over the teeth after we clean them with pumice or air abrasion.
Anytime you can say, “Hey, I won’t touch your teeth, I won’t cut into them—and it’s cheaper and, theoretically, reversible,” it’s a win for everybody. Every time we see this patient, she’s still happy about it, and her gums are nice and healthy, because there is no violation of the tissue at all.
3M FILTEK MATRIX
While composite bonding offers a fairly simple way to repair damaged anterior teeth, freehanding the procedure can be time-consuming and unpredictable. The 3M Filtek Matrix offers a blueprint for better cosmetic bonding in just 3 easy steps: Diagnose and scan the patient’s teeth; approve/make changes to the digitally designed restoration in the webbased 3M Oral Care portal; receive the 3D-printed 3M Filtek Matrix in about 2 weeks and deliver the composite.
Dr. Hodges graduated from the Medical College of Georgia School of Medicine in 2000. He practices at Hodges and Hodges Comprehensive Dental Medicine, Asheville, NC. While offering expert treatment for patients, Dr. Hodges and team focus on the latest technology and research in dentistry, as well as ongoing training and education.
