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An introduction to a modern procedure for anterior composite restorations and black triangle closure using a novel matrix system: part 1 Claire Burgess Dominic Hassall Dental Update 2024 50:2, 707-709.
Restorative, Prosthodontic and Periodontal Specialist, Director, Dominic Hassall Training Institute; Senior Clinical Lecturer School of Dentistry, Cardiff University
The Bioclear Method is a modern approach to direct composite restorations that gives both patients and dentists the longevity, both cosmetically and functionally, that they desire. This article explains the principles of the Bioclear Method and presents clinical cases where the Bioclear Method has been used. The article also includes examples of black triangle closure, a patient concern that practitioners have been reluctant to treat in the past using traditional composite methods.
CPD/Clinical Relevance: This article highlights a clinically relevant and modern method that can be used for placing all direct composite restorations.
Article
Patients and dentists look to direct composite restorations as a way for replacing existing stained or metallic restorations, repairing chipped or fractured teeth, correcting the shape of teeth, and correcting spaces (including black triangles) between teeth. Issues that both patients and dentists have with traditional layered composite restorations is the high level of chipping and staining that can occur, often within a short period of time.1 The Bioclear Method (Bioclear, Tacoma, WA, USA) is a modern approach to direct composite restorations that potentially gives both patients and dentists a systematic set of procedures that simplify composite techniques to create predicable patient-centred outcomes.
Composite resins, a combination of monomers and filler particles, were first introduced to dentistry in the 1960s. Over time there have been advances with both the composite materials and their ability to bond to tooth structure. Development of the acid-etch technique by Buonocore, and the Bis-GMA resin by Bowen, transformed composite restorations.2,3,45 Bonding to enamel is highly predictable as it consists of 96% inorganic apatite.6 Bonding to dentine, however, still remains less predictable because it consists of an inorganic apatite within a collagen and water matrix.7 The bond with dentine, especially secondary dentine, degenerates over time, resulting in reduced long-term stability. The development of the total etch technique helped to compensate for this by increasing the bonding strength of the composite to the dentine. Through the application of 37% phosphoric acid to the dentine for a maximum of 15 seconds, the total etch technique removes the smear layer, opens the tubules and decalcifies the coronal intertubular dentine. This results in a dense collagen network that can then be penetrated by resin.8,9,10
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