PDF Version - Glidewell Dental Labs
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Figure 32: Next, we syringe an initial layer of<br />
Vertise Flow into the preparation. As shown<br />
here, this composite contains a self-etching<br />
bonding agent that is activated by using a<br />
disposable brush to burnish the material into<br />
the dentin for 20 seconds. In reality, you end up<br />
removing most of the first layer from the prep<br />
while doing this, but the point is to get a very<br />
thin layer in close contact with the dentin.<br />
Figure 33: Here we are light-curing the initial<br />
layer of Vertise Flow for 20 seconds. The light<br />
curing actually stops the self-etching of the<br />
dentin that was taking place. Now that we have<br />
that layer bonded to the dentin, we can add 2<br />
mm layers of Vertise Flow, curing for 20 seconds<br />
between each increment. As we are just bonding<br />
composite to composite at this point, there is<br />
no need to use the brush or agitate the material<br />
any more. The process simply is to add some<br />
material, light cure and repeat. Most flowables<br />
won’t support their own weight, so you are<br />
better off placing them in smaller increments.<br />
32<br />
Figure 34: I always slightly overbuild these<br />
types of small build-ups, or fillers. I want to be<br />
able to prep it back flush against the natural<br />
tooth, so that I don’t leave an undercut in the<br />
tooth. We receive far too many maxillary anterior<br />
impressions at the lab with multiple undercuts<br />
in the teeth where direct composites used to<br />
be. Not only does this cause the impression to<br />
distort, but it also creates weakened dies. It is<br />
my hope that a simplified build-up technique<br />
like this one with Vertise Flow will help more<br />
dentists invest the time needed to place and<br />
charge for these build-ups.<br />
33<br />
34<br />
26 www.chairsidemagazine.com