Palatal Shelf Technique on #8 MIFL

Introduction to the case

Pipe to the face chipped the MIFL composite on #8. The most predictable way to do these for me is to use the “palatal shelf” technique with the shelf being made of a super thin layer of enamel shade composite, then a dentin shade composite to replace all the dentin, and then the last .5 mm being enamel shade again.

To create the palatal shelf, a matrix is needed and there are 3 methods to get it:

  1. Do a preop waxup and create a putty on the model (most ideal)
  2. Do an intraoral mockup very quickly and then create the putty in the mouth
  3. Finally, what I usually do just for the sake of time is I’ll make the putty with no mockup and then use a bur to create the “negative impression” to where the tooth should be (BRB technique). This is obviously easier when there’s not a lot of tooth missing.



6 Minimally Conservative-Preparation Porcelain Veneers


Introduction to the case

Patient received 6 porcelain veneers with minimal or conservative teeth preparation. The prep process was conservative to minimize removal of tooth structure. The images show tooth discoloration caused by old composite bondings. Following treatment, the teeth are whiter and less crowded.



Lengthening Anterior Teeth With Composite

Terry Shaw

General Dentist

Perth-Ando​ver, N.B, Ca​nada


Introduction to the case

69 year old gentleman came in for consult on bonding. Recent crown on right canine had broken off and he was balancing it in place. Lots of wear on remaining anterior teeth. He came back 2 weeks later for an elective root canal so I could place a prefab metal post and bond his crown in place. He was back a month later when I bonded his 5 remaining anterior teeth.

Some one placed a case asking for help with lengthening anterior teeth and I discovered these pictures buried in my computer so thought I’d post them to maybe help answer some questions about the problem.



Anterior Composite Buildup Using Bioclear Matrices

Introduction to the case

This is my 2nd Bioclear case, just looking for feedback again from all you bondadontists. This one is more Doc Terry style.

91 y.o. male, didn’t like how worn his teeth were.

Filtek SU and Beautifil flow+ again.

It’s a lot of composite, but at age 91 I may have time on my side. You can’t tell from the pictures but the “crowns” are very thick, which I hope will compensate for the lack of posterior occlusion.

Still figuring out the technique. Big thanks to Doc Terry for making it seem possible, in the past I would have told him he needed RCT/post/crowns or a denture. This seems like a good compromise.



Immediate Implant with Cement Retained Provisional Crown

Introduction to the case

Pt. presented w/ #8 w/ severely resorbed root (from ortho extrusion) and symptomatic. Pt. has very low smile line which works in our favor. Tx. planned for extraction, immediate placement and provisional. 4.3X13mm Nobel replace select groovy implant placed and temped using nobel screw down temp abutment. Picked up the white cylinder w/ luxatemp and tooth taken out of occlusion and all movements. Immediately temping this case with the temporary abutment and cement retained provisional crown worked nicely.



Endo Retreatment with CBCT Showing Transported Canal with a Perforation

Craig Berry

Endodontist, Diplomate


Introduction to the case

Fun retreatment. Patient had RCT on 9, which was retreated by another endodontist 5 years ago. Patient developed pain and swelling in the area. CBCT revealed a transported canal with a perforation. I was able to locate the canal and hopefully save the tooth!



Composite Full Mouth Rehab Using Activa Bioactive Restorative

Introduction to the case

This is one of my most MacGyver cases to date. This patient has extensive damage from wear and erosion and was ready to restore his mouth before it gets any worse. He is now a faithful nightguard wearer but nonetheless, those masseters made me really nervous.

I like to test drive big cases in composite before committing to porcelain because if they’re going to be breaking stuff, it sure helps to figure out why and correct it before proceeding to finals. You can certainly do it with just a bisacryl overlay but it tends to pop off and you can’t really leave it on as a buildup. Doing the mockup in a real composite allows you to break the teeth up individually for flossing and allow them to wear it longer. It also serves as a buildup by filling in deficient areas of tooth.

In this case, I generated a template from a waxup and used it to injection mold the intraoral mockup. The contacts were broken by inserting mylar strips interproximally.

I chose to use Activa here for a variety of reasons. It is injectable, it’s dual cure, it doesn’t have to have a bonding agent, and it is very resistant to wear and chipping. The bioactive aspect is icing on the cake making it far less likely to have secondary decay.