Esthetics of Dental Composite and Adhesive System

Diagnostic Test - Pulp vitality testing

each tooth will be tested to determine if the pulp of the tooth responds to cold

Photos

Photos of teeth (Photos will be taken with a DSLR camera settings will be determined with optimal settings) and captured periodically throughout the study. Photographs will be made of the cavity preparation. Photographs will be made post-operatively

Drug - local and/or topical anesthetic

Local and/or topical anesthetic will be applied as necessary to the teeth or gingiva

Device - rubber dam

The area will be isolated with rubber dam isolation

tooth surface cleaned

The tooth surface will be cleaned with flour of pumice on a prophy cup only, cavity preparation will be performed as usual for caries removal.

Procedure - enamel margins

Enamel margins will be beveled with a long flame diamond bur (8863.314.012 Komet) at 45 degrees to the external tooth surface to achieve the desired bevel length. Along with the use of the diamond bur, infinite invisible margins will be created by contouring and smoothing with a dark orange Sof-LexTM extra-thin contouring and polishing disc (3M).

Procedure - Adhesive Systems

Adhesive systems will be applied according to manufacturer's instructions and selective etching of the enamel will be performed. The dental composite will be incrementally placed using a two- layer or one-layer technique based on the cavity size and light-cured (detailed adhesive instruction sheet will be chairside for reference)

Procedure - cavity preparation

The technique to be used will be determined by the size of the final cavity preparation. For small preparations a one-layer technique will be used. No backing material is necessary for the Tokuyama system, Filtek Supreme Ultra will be determined by manufacturer's wheel. A two-layer technique will be used for a large cavity preparation. Large cavity preparation is defined as being 4mm in length or more and/or at least 2mm in depth.

Shade selection using Easy Shade 5

A1 (shade determined by Easy Shade 5), ECM-001/Backing material, A1E/A2D (shade will be selected by shade wheel) A4 (shade determined by Easy shade5), ECM-001/Backing material, A3E/A6D (shade will be selected by shade wheel

Procedure - Light Curing

A Valo Grand curing unit (Ultradent) with an exitant irradiance with no less than 500 and no greater than 1500 mW/cm2 as measured with MARC Light Collector will be used in standard mode to deliver the required radiant exposure J/cm2 for adhesive and dental composite increments.

Procedure - Contoured and polished

The restoration will be contoured and polished with - Long flame diamond bur (8863.314.012 Komet), Sof-Lex Medium (orange) Contouring and Polishing Discs (3M), Green Jiffy cup pre-polisher (Ultradent Products, Inc.), Blue and grey silicone points composite polisher gloss plus finisher (Kerr Hawe)

Consent

The consent form will be signed, copy will be provided to the patient

Health Questionnaire

The health questionnaire will be completed at initial visit and updated at each follow-up visit

Radiation - xray

When necessary a radiograph (xray) will be obtained

Release of medical information signed

The release of medical information form will be signed

Oral Exam

An Oral Exam will be completed

Teeth Assessment

The teeth assessment by subject will be completed using the Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) at the follow-up visits 1 month after restoration, 1 year, 2 years and 3 years post restoration.

Clinical Assessment

A clinical assessment will be completed by the evaluators

Device - Tokuyama Universal Bond

Tokuyama Universal Bond (TUB) single component self-etching 1-step adhesive system with Tokyuama supra-nanofilled dental composite (ECM) (Tokuyama Dental Corp., Japan)

Device - ScotchBond

Scotch Bond Universal one-step adhesive system with Filtek Supreme Ultraâ„¢, nanofilled dental composite (3M)