Dentaltown March 2020 - 73

Fig. 1: Bioclear matrices in place in preparation
for warm-injection molding.

Figs. 2a and 2b: Natural teeth before and after
preparation for porcelain veneers. Significant
tooth structure was lost permanently.

structure is frequently removed for "draw,"
dark-triangle correction or hiding of margins.
Warm-injecting composite into shaped
matrices allows dentists to do additive
dentistry with infinity margins and thicknesses at little as 0.01mm. Patients benefit
because none of their tooth structure has
been destroyed and their teeth and smile
are renewed.

Why combining the three
methods is important
One issue I had when I tried using only
matrices and warm-injection molding to
complete direct composite veneers was the
amount of disking and contouring needed
after the warm-injection process.
To get a dense injection that surrounds the
tooth, an excess of material must be expressed
to get the monolithic strength-but that
leaves a large amount of composite cured on
the facial that needs to be contoured to look
like an incisor or cuspid. This takes most

practitioners a lot of time to disc, contour
and polish-not to mention the need of
artistic talent to make it look like a natural
tooth. Even though the monolithic base made
this way is stain-resistant and strong, in my
opinion most dentists don't know how to
do this efficiently, which keeps them from
considering doing direct composite veneers.
Meanwhile, using only the templates
revealed inherent weaknesses as well: I
couldn't control the interproximal margins,
and the templates couldn't be used to close
dark triangles.
Using the Uveneer templates to shape
the facial of the Bioclear method veneers,
however, revolutionized my technique. I press
a template onto the facial of each tooth before
the composite warm-injection mass is cured
(Fig. 3); once it's in position and the excess
composite has been cleared from the facial of
the template (Fig. 4), the composite is cured
thoroughly from facial and lingual. Three
surfaces-mesial, distal and facial-have all
been sealed from oxygen while curing, which
leaves an oxygen-inhibited layer, meaning
you get dense, strong and polished surfaces.
Then, I remove the matrices and tease
the template from the facial of the tooth:
The mesial and distal of the tooth have been
shaped by the matrices, and the facial has
been shaped and polished by the templates
(Fig. 5). These surfaces are smoother than
polishing could accomplish because the
composite has been cured against the matrices' smooth mylar and the inner or intaglio
surface of the template, which leaves the
underlying surface utterly smooth. If you've
done careful work, you won't need to polish
the mesial, distal and facial surfaces at all.
The only contouring needed is the blending
of the junction points of the templates and
matrices, and the incisal edge will also need
to be checked and trimmed so it matches
that of other anterior teeth (Fig. 6).

Fig. 3: Warm flowable and paste composite
injected onto tooth and into interproximal areas
before Uveneer matrix is pressed over the
composite.

Fig. 4: Excess composite removed from around
the Uveneer template.

Fig. 5: Smooth appearance of facial surface
directly after template removal saves time
in shaping and polishing.

Fig. 6: Using a 3M medium disc to refine
incisal edge.

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Dentaltown March 2020

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