Class II MOD Restoration

John Comisi
Author: John Comisi
Date: 11/29/2012 01:07pm
Share |
Rate this Article:

A 43-year-old female patient presented for a routine dental examination and periodontal maintenance procedure. An oral evaluation revealed that she was managing her periodontal condition, and that she had successfully stopped smoking for 18 months.

I performed a visual intraoral examination using 4.0x-500 loupes (Rose Micro Solutions), and an SDI diagnostic transillumination attachment on an Radii Plus curing unit (SDI).

An evaluation of the patient’s dentition revealed a failing existing distal-occlusal composite restoration on tooth No. 12 that was placed in June 2008. In addition, there was a development of a mesial marginal ridge fracture of that same tooth, which I identified with the use of the SDI diagnostic attachment.

Using these tools, the diagnosis was that a Class II restoration on the mesial, occlusal, and distal surfaces was needed. I discussed this diagnosis with the patient as well as the treatment option of a direct composite restoration. The patient agreed.

The patient chose this option for its direct and conservative approach. She also wanted to have a tooth-colored restoration. I decided to use a modified resin cone technique1 that I developed using Beautifil Flow Plus 00 and 03 (Shofu) with ALL-BOND UNIVERSAL bonding agent (BISCO) to reduce the polymerization shrinkage and internal stresses that can develop with typical composite restorations.

The final outcome resulted in a very successful mesial-occlusal-distal restoration.


Modified Resin Cone Restorative Technique

•     Place an appropriate matrix and wedge system and use a total- or self-etching bonding agent on the restoration.

•     Use Beautifil Flow Plus 00 (Shofu) in the proximal box and cure the material.

•     Place more Beautifil Flow Plus 00 in either the other proximal box or at the point farthest away from the previously placed material. Cure the material.

•     Fill the space between the 2 Beautifil Flow Plus 00 resin cones that were placed and cured with Beautifil Flow Plus 03 (Shofu). This step will connect the 2 previous segments together. Cure the material.

•     Remove the matrix and wedge.

•     Trim and polish the completed restoration.


Comisi After


Comisi Before


Figure 1


Figure 2


Figure 3


Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Category TagsDental Materials and Biomaterials, Periodontics, Restorative Dentistry

Article Related Content Type

Deep Facial Caries Treatment

Author: John Comisi
Date: 08/30/2013 09:12am

A 37-year-old healthy female presented for new patient examination and evaluation. She had not had dental care in more than 6 years and was concerned with the appearance of her front tooth.

Read more