FIGURE 1
Comprehensive Composite Restoration
I. TREATMENT PLANNING
1. Smile
Design
Restorative Situations
A. Smile Shape
Class 1
Arch size, position and
shape Class 2
Arch to arch
relationship
Class 3
Gingival position, shape, and
contours
Class 4
Overall incisal edge position
and shape Class5
Tooth to face proportion,
shape, and position Surface Defects
Midline placement, tilt, and
arch to arch relationship Peg Laterals
Perspective
Diastema
Symmetry
Papillae loss
B. Tooth
Shape
Veneers
Silhouette
Form
Inlays
Gingival
contour
Onlays
Incisal
edge
Crowns
Embrasure
form
Splinting
Contact
placement and size
Rotations/tipping
Face
Form
Congenital Defects
Line angle
placement and shape Porcelain
Repair
Gingival
height of contour
Composite Repair
Incisal
shape
Tooth Replacement
Long
Axis
Implant Access
Meisal/Distal,
Labial/Lingual
Periodontal Splinting
Surface
Contours
Flat,
concave, and convex
Surface
Texture
Smile Imperfections
General
uniform texture
Individual
grooves and dimples Tooth Color
Tooth
Color
Craze lines
Tooth to
tooth
Decalcifications
Arch to
arch
Fillings
Discoloration
2.
Color
Stains
Dentin exposure
A. Color
Examination
Cavities
Observing and recognizing:
Tooth
Position
hue, chroma, value, fluorescence,
translucency
Tipping
B. Color
Replication
Rotation
Understanding materials to
produce and match: Crowding
hue, chroma, value, fluorescence,
translucency Tooth Loss
Diastema
3. Tooth
Color
Intrusion
Extrusion
A. Normal
Arch shape
Incisal and interproximal
translucency
Tooth Structure
Body
shade
Chips
Gingival
transition
Cracks
Local color: stains, grooves,
etc
Abrasion
B.
Abnormal
Attrition
Aging, stains, developmental,
wear, etc Wear
Surface Defects
4. Tooth
Shape
Surface Texture
Gingival Contours
A. General shape: square, oval,
etc
Cavities
Face: Incisal edge, line angles,
and gingival contour Developmental
Silhouette: embrasure, incisal edge,
gingiva, contacts
B. Surface contours and
texture
General contours, dimples, grooves,
convexities, concavities
5. Tooth Position
Tipping, rotation, super eruption, under
eruption within arch
Arch to arch
6. Esthetic Goals
A. Limitations to Ideals
General appearance,
emotional, environmental
B. Limitations to Treatment
Physical, financial,
psychological
II. COMPOSITE RESTORATION
7. Tooth Preparation
Preparation design
Bur/instrument selection
Surface bonding and
mechanical retention/resistance preparation
Enamel finishing
8. Bonding Techniques
Techniques for enamel, dentin, other dental
material bonding
9. Material Selection
A. Restoration Color
Material
Hue, chroma, value,
translucency, florescence
Tints and opaque
B. Defect Analysis
Tooth Backing
Color of
defect
Hue, chroma, value, translucency
Defect size
Defect shape
No Tooth Backing
Defect size
Defect shape
C. Restoration Strength
Force Analysis
Direction
Lateral, compressive, shear, rotational
Magnitude
Frequency
Occlusion
Para
functional habits
Grinding, biting nails, etc
Resistance to Force
Physical
Characteristics
Shear, tensile, compressive, modulus of elasticity, etc
Material
thickness
Material
resistance to cracks and crack propagation
Technique
complexity
Support Strength
Preparation
design
Bond strength
Surface area
Material
composition/quality of tooth structure/techniques
Tooth strength
Cross section
Type and
quality of structure
D. Wear
Strength and frequency of
abrasive, adhesive, chemical, corrosive and fatigue wear
Placement and pre cure
shaping characteristics
E. Ease of placement
F. Ease of precure shaping
G. Ease of post cure shaping
H Surface polish characteristics
I. Stability of polish
J. Color stability
10. Material Placement Techniques
Isolation
Matrix techniques
Color replication
Strength
Health
11. Composite Shaping
Technique
Instrumentation Selection
12. Composite Finishing
Techniques
Instrumentation
