Layering anterior composites has almost become the standard of care today. With products on the market like Estelite Omega by Tokuyama, composites can be fun, beautiful, and relatively easy to place with some practice.

I’ve become pretty dependent upon the use of a wax-up to layer my composites, and it’s my go-to material of choice. I usually try and see if I can talk myself out of composite before considering porcelain. When we can plan and have complete control over a situation, it’s ideal.

But emergencies happen. Last week I had a new patient come in that had fractured off previous bonding the night before. She stayed home from work and wasn’t comfortable seeing anyone until the break had been repaired.

anterior composite emergency patients

Rather than bulking and cutting back to achieve the shape I desired, I created an intraoral matrix to use in the same way I use one from a wax-up. I did this by placing a single shade of direct composite. I placed it pretty quickly and polished slightly. I didn’t etch or place any adhesive, so after creating a lingual matrix, it popped off easily.

I then created a facial bevel and lingual chamfer and used the matrix to place five layers of composite with some tints to match the adjacent teeth. 

Actual treatment took about 40 minutes start-to-finish after determining the plan and discussing what we’d do. I could never have achieved this result without a lingual matrix in that amount of time.

This is an easy way to simulate a wax-up when necessary in an emergency situation, and you’ll rarely find a more thankful patient!

(Click this link for more dentistry articles by Dr. Courtney Lavigne.)

Courtney Lavigne, D.M.D., Spear Visiting Faculty and Contributing Author - http://www.courtneylavigne.com


Comments

Commenter's Profile Image Josh R.
April 3rd, 2019
Great technique Courtney! My go to has been to create a lingual matrix first then use a hand piece to “carve out” the missing section of tooth out of the matrix. Your way provides direct visualization which is a great advantage. Great work!