From: Marga Ree
To: ROOTS
Sent: Friday, September 17, 2010 1:01 PM
Subject: [roots] Cosmetic build-up

This patient came in with a cosmetic problem, his lateral incisor snapped off.
I made a cosmetic build-up, used LuxaCore to cement the post and make the build-up.

In this case, the shade of the core material was a bit light, so we veneered the buccal surface
with a flowable composite of a darker shade.

Shade and shape of the BU are not perfect, but good enough to be used as a temporary restoration
that seals well and won't come loose. Moreover, the fit is way better than that of a
temporary crown with a temporary post - Marga





Love it!!! Congratulations (again and again and again) for such nice cases, and for share them
with all of us. What type of matrix have you use? How do you manage to fit it so well to the tooth?
Thank you very much - Javier

Thanks Javier,

The matrix I use is custom made, I use the core formers by Kuraray. Cut the upper part away with a scalpel,
and turn the form upside down, insert it in the sulcus, so that the smallest diameter is at the cervical
part of the tooth that has to be restored, and the widest part is going to be at the occlusal surface.
This gives you a kind of a tooth model. A wedge is usually not necessary. After having used the system
for many years, I can estimate pretty accurately which size I need, and how to customize them.
After applying the composite, I give some pressure with indexfinger and thumb from buccal and palatal,
to adjust the form a bit. After the composite has set, you can easily adjust the shape with diamonds and
finishing burs. I don't mind if a don't have a contact point. Usually it is better to have no contact
point at all than a loose contact point, it is only  a temporary restoration.

The main problem with the metal bands is that they can easily cut the gingiva, which can be very annoying
because of the subsequent bleeding, in particular when you are going the do an adhesive procedure requiring
a dry field. The plastic is very gentle in this respect, and when you are able to create a tight fit,
the matrix surrounds the remaining tooth structure circumferentially without the slightest gap.
I always try to make it slightly too narrow, and when I place it, the plastic will act like a rubber band,
it will stretch a bit, creating a tight fit. - Marga