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In this post I’ll share my cusp-by-cusp protocol to naturally restore lower posterior teeth! 

Comment LOWER RIDGES. for my free morphology guideline!
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Back-to-back Class II restorations

Two adjacent restorations, one step-by-step workflow.

From preparation and bonding to matrix placement, contact points and final anatomy. Swipe through to see how I approach these cases!

In the next post, we’ll take a closer look at the cusp-by-cusp layering technique and how to recreate natural posterior morphology.
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***BLEACH - INFILTRATE - BOND***
For this young patient, severe MIH affected her life much more than appearance. Sensitivity made brushing and eating almost impossible. Using the Bleach–Infiltrate–Bond (BIB) protocol, the affected teeth’s function and appearance could be restored with a minimally invasive approach.

#minimalinvasivedentistry #estheticdentistry #enameldefects #bleachinfiltratebond #karma

***BLEACH***
After 20 days of home bleaching with 5% carbamide peroxide (Flairesse 5% CP, DMG), a rest period of 4 weeks was planned. Next, the teeth were isolated with a rubber dam secured using flowable composite. Then the enamel was air-abraded with aluminium oxide (AquaCare, Velopex) and etched with 15% hydrochloric acid (Icon Etch, DMG).

#dmgicon #infiltration #rubberdamfam #icondmg #rubberdamology

***INFILTRATE - PRE-TREATMENT***
Ethanol (Icon Prime, DMG) was used at several stages to assess the permeability of the hypomineralised enamel. At this point, a small amount of superficial enamel was removed with a low-speed diamond bur to facilitate better penetration into the affected enamel. 

#dentistry #dentista #zahnmedizin #schmelzdefekte #adhesivedentistry

***INFILTRATE***
After four etching cycles, deep infiltration was carried out with Icon Infiltrant (DMG) for 20 minutes. Following a 40-second light cure, the infiltrated enamel was air-abraded and etched with phosphoric acid.

#cosmeticdentistry #teethwhitening #restorativedentistry #minimalinvasivedentistry #tandarts

***BOND***
Following application of an adhesive layer (OptiBond FL, Kerr), the defects were restored with a supra-nanofilled composite (Estelite Asteria, Tokuyama).

#cosmeticbonding #compositebonding #karmadentistry #tooth #tannlege

***EVALUATE***
8-week follow-up after treatment of the upper & lower jaw using the Bleach-Infiltrate-Bond (BIB) protocol in a case with severe MIH. Oral hygiene improved tremendously and she could enjoy eating again. Minimal invasive treatment, big impact!

#odontologia #dentisterie #치의학 #歯科医療 #kedokterangigi

***EDUCATION***
Do you want to learn how to use the BIB-protocol and become a Master in the treatment of enamel defects? Join my online Infiltrati
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