Dr Lincoln Harris

Composite Step by Step

Detailed steps for doing a posterior composite filling

To continue watching, subscribe and become a RipeGlobal member

In this video, you will learn detailed steps for doing a posterior composite filling, as demonstrated on a premolar. In this case there is a crack distally to the amalgam and caries.

Sections in this video:

1. Isolation - Learn rubber dam placement tips and problems that can occur with rubber dam, particularly with rubber dam that is not good quality. The importance of sealing the rubber dam properly to ensure good isolation throughout the procedure is discussed.

2. Filling Prep - In this case it's difficult to determine the form of the crack and the amount of caries so I remove the amalgam first. Learn why it is important to remove demineralised enamel before bonding. 

3. Plaque Disclosing and Air Abrasion - Learn the importance of using plaque indicator to identify plaque. In this case, the plaque cannot be seen initially, however there is a significant amount of plaque which even selective etch wouldn't get through.  I explain my use of a metal band to protect the surrounding teeth when sandblasting and discuss the benefits of flaring the cavity in order to create a flat surface that lessens the stress placed on the bond.

4. Bonding and Matrixing - Learn in depth process of my method of bonding. SE bond is used and selective etch (SE Bond doesn't have enough etch power on it's own). I discuss positioning the matrix band and the importance of having the gingival margin completely sealed. 

5. Composite Layering - Methodologies include: use of Gluma, 20 second curing of the adhesive with a thin layer of flowable, use of a microbrush to pack heated composite and flowable between the composite layers. Learn why in the final increment of the restoration I don't cure it fully.

6. Finishing the Restoration -  Tips given on adjusting the marginal ridge, ensuring any gaps in the tooth are sealed and recreating the occlusion for aesthetics and function.