Greater Curve Standard Brass Band- MODL composite #2

Introduction:

The malleability of the Greater Curve brass makes it easier to burnish desirable contours and make contact openings.

Before #2

Step 1

Prep

Step 2

Considered recommending a crown, but there was sound dentin supporting the remaining cusps.

Greater Curve brass in place

Step 3

The brass is very malleable. Note how the brass remains crimped over the adjacent tooth's marginal ridge which made it easy to visualize placement of the contact opening. I tried to position the mirror in order to show the contact opening but I could not get the mirror angled properly.

Composite

Step 4

I used Activa A2 as a base and placed Filtek on the occlusal surface.

Final

Step 5

MODL composite tooth #2

Conclusion:

Activa (Pulpdent)

Advantages:

1) Easy and fast to place because it is a flowable.

2) So far it appears to wear as well as any other composite.

3) Margins are stain resistant and blend well

Disadvantages:

1) Easy to capture bubbles on the margins and within the composite.

2) More fracture prone than conventional composite. Pulpdent says otherwise, but that has not been my observation.

Based on my observations from above, this is how I use Activa clinically:

• Class V's. It blends beautifully against the tooth. Margins are stain resistant.

• Buildup under crowns. I like the bioactivity.

• Conservative Class II’s, Class III’s.

• As a base under large Class II’s and Class IV’s. I place Filtek over the Activa for color control and fracture resistance.