![]() Once checked, the intaglio surface of the onlay was air abraded by 50 microns alumina particles, washed, conditioned with 35% phosphoric acid gel ( Ultra etch, Ultradent) and placed in an ultrasonic bath for two minutes for cleansing. Heavy rubber dam sheet placed for isolation Heavy rubber dam sheet placed for isolation and the indirect composite onlay checked for fit and marginal integrity.įig 6. Onlay conditioning & Bonding protocol – Once the restoration was ready, the patient was seated, and the tooth prepared for bonding. Then the intaglio surface was further cured for 60 secs to minimize shrinkage. Composite complete coverage restoration was fabricated and removed from the dye. In the final composite layer dark brown tints ( Color plus, Kerr) were used to mimic pits and fissures of a natural tooth. Alginate impression of the prepared toothĪ light cured composite resin ( Ivoclar Vivadent), was used to build the onlay in an incremental fashion and each layer was cured for 20 secs with a curing light ( 3M). Once the stone was set, a dye separator ( Shofu Dental) was painted on the cast to ensure that the resin does not stick to the dye.įig 4. Indirect restoration fabrication – Post the onlay preparation, an alginate impression was made and poured immediately in die stone to retain all the details. Cuspal reduction with a clearance of 2-2.5mm The margins were placed supragingivally, away from the gingival zenith by 3 mm (buccally) and 2 mm (palatally & proximally).įig 3. The clinical tooth height was 6 mm, and an occlusal clearance of 2mm on the non functional cusps, and of 2.5 mm on the functional cusps was achieved. The undermined enamel and the proximal caries were removed as we achieved a 360 degree enamel margin for enhanced bonding. Onlay tooth preparation – We began with anesthetizing the tooth. It was decided to fabricate an indirect restoration in the clinic and bond to the prepared tooth at the same appointment to reduce the number of sittings and cost to the patient. Preoperative clinical picture, buccal view showing food lodgment Pre operative clinical picture, occlusal viewįig 2. Due to the need for complete occlusal coverage, an indirect restoration was planned and composite was the material chosen.įig 1. On clinical examination it was observed that all four cusps needed build up while there was no pulpal involvement. Case ReportĪ 48 year old male patient visited our practice with a chief complaint of sensitivity and difficulty in chewing hard food. In theory, the indirect way should also reduce polymerization shrinkage, micro leakage and color instability in comparison with the direct composite restorations, though further long term studies are needed. The indirect composites, used to rehabilitate large defects owing to decay or fracture of the tooth help the clinician to overcome practical issues such as time management, difficulty in building the occlusal anatomy and tight proximal contacts. Pulling on a brown string attached to the colophon leaf (leaf 9, a double leaf that does not unfold) will expand the spine to lay the leaves flatter.Although direct resin composites are the most common restorative option for missing tooth structure, the indirect composite restorative techniques are still not our go to option in many practices. One edge of each folded leaf is tacked with thread to a thin metal dowel and sewn through an accordion-pleated spine. There are sixteen books and four artist proofs in the edition" - Colophon. Garamond type set by Michael and Winifred Bixler and printed by Brad Benedict, Blacks Corner Letterpress. Digital images printed onto the intaglio prints by Chris Tague at the Experimental Printmaking Institute at Lafayette College. Intaglio plates by Kumi Korf, printed by Christa Wolf at Rikka Press, Ithaca, NY, on Copperplate Hahnemuhle paper. "Calligraphy on the title page by Kumi Korf. Text and the original video stills by Mario Korf, a freediver/hunter-gatherer living on the Pacific Coast in California" - Colophon.
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