Composite question

[DancingKoala]

Hi guys.
I did class 1 restoration about 2 weeks ago and it needs to be done agian.
The reason is because the opposing cusp is hitting on the triangular ridge instead of
central fossa. I basically had to scoop out the composite to have nice occlusion but this composite can't last long due to it's shape, and thickness.
Basically, the solution is to re-create a nice triangular ridge and instead of adjusting the composite, we will grind down the opposing cusp.

My question is, is it ok to just etch, bond, and put composite over the composite I had before? Or do I have to remove all the composite out and re-do everything all again?

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[bsp1013]

Hi guys.
I did class 1 restoration about 2 weeks ago and it needs to be done agian.
The reason is because the opposing cusp is hitting on the triangular ridge instead of
central fossa. I basically had to scoop out the composite to have nice occlusion but this composite can't last long due to it's shape, and thickness.
Basically, the solution is to re-create a nice triangular ridge and instead of adjusting the composite, we will grind down the opposing cusp.

My question is, is it ok to just etch, bond, and put composite over the composite I had before? Or do I have to remove all the composite out and re-do everything all again?

Check the bite and get the occlusion right (either relieve the composite or take away from the opposing tooth)

Yes, you can add to existing composite. Dovetail it into existing resto for added retention.

 

[Contach]

Yes, you can add to existing composite. Dovetail it into existing resto for added retention.

It's been a while... but I believe that if you want to add composite to composite, you need to use a silane primer, bonding agent, and then add new composite. This method allows for some (albeit weak) chemical retention. You can consider microetching the previous composite as the very first step as well (sand blasting with Al2O3). This roughens the surface, aids with mechanical retention.

Etching old composite is worthless, you etch teeth, to open enamel rods and dentinal tubules - there are none of these in composite. Even with the saline primer, you won't get the same bond strength as you would if you drilled out the previous composite and put a new one in... With that said.. if you are planning on removing the composite: you are going to make the prep bigger, no matter how hard you try... So it seems like you are losing either way... I don't understand why you can't just adjust the composite...

The dovetail idea is a good one to obtain mechanical retention. But how does this fair vs microleakage?

 

[bsp1013]

It's been a while... but I believe that if you want to add composite to composite, you need to use a silane primer, bonding agent, and then add new composite. This method allows for some (albeit weak) chemical retention. You can consider microetching the previous composite as the very first step as well (sand blasting with Al2O3). This roughens the surface, aids with mechanical retention.

Etching old composite is worthless, you etch teeth, to open enamel rods and dentinal tubules - there are none of these in composite. Even with the saline primer, you won't get the same bond strength as you would if you drilled out the previous composite and put a new one in... With that said.. if you are planning on removing the composite: you are going to make the prep bigger, no matter how hard you try... So it seems like you are losing either way... I don't understand why you can't just adjust the composite...

The dovetail idea is a good one to obtain mechanical retention. But how does this fair vs microleakage?

Never heard of using silane to repair composite. I believe that's what you would use to add resin to porcelain though. Just use your bonding agt (primer too if you're not using a one bottle system)

As far as the micro leakage issue, I think the comp.-tooth margin would start leaking before the more recently repaired area would. There's plenty of research on this topic though, and adding/repairing existing comp. is perfectly fine as long as there is no decay underneath.

 

[Mackchops]

Never heard of using silane to repair composite. I believe that's what you would use to add resin to porcelain though. Just use your bonding agt (primer too if you're not using a one bottle system)

As far as the micro leakage issue, I think the comp.-tooth margin would start leaking before the more recently repaired area would. There's plenty of research on this topic though, and adding/repairing existing comp. is perfectly fine as long as there is no decay underneath.

Composite bonds to composite as long as there is still an oxygen inhibited layer - this is why we can layer our composites. But if it's been polished away, or you're a couple weeks out you would need to lightly prep the surface that you're going to repair (roughen more than prep), and use your bonding system and composite just like you were placing a new restoration. Cure, polish, and you'll be fine. There is absolutely no need for silane in this situation - that's used in porcelain bonding.