1. An occlusal preoperative view of a patient presenting with defective amalgam restorations on teeth 11, 12 and 14. Tooth number 13 has a porcelain-fused-to-metal crown with recurrent decay. It has also had previous root canal therapy requiring a post and core buildup. Due to the functional and esthetic needs of the patient, it was decided to place bonded esthetic restorations.

2. Teeth 11, 12 and 14 have been built up with CoreRestore2. Tooth number 13 had a fiber post bonded in place using Nexus2 Universal Luting Cement. A maxillary premolar core form was selected and a hole placed into the top of the form to allow complete seating over the fiber post. The strength of CoreRestore2 provides a solid foundation for a long-term esthetic result.

3. Take 1 Super Fast Tray material is used to construct a provisional matrix. The firm viscosity and quick intraoral set time of 1:30 are ideal. Temphase is extruded into the matrix and the unit placed over the preparations. The patient is instructed to close into the matrix and hold it in centric occlusion for 2 minutes.

4. The polishability and shading of Temphase give it a look almost as natural as the definitive restoration.

5. Expasyl alone displaces gingival tissues adequately for final impressions in many clinical situations. The key to successful Expasyl placement is keeping the dispensing tip parallel to the long axis of the tooth. Correctly displaced tissue will have a blanched appearance. In this case, the restorative margins are located about one millimeter subgingival, therefore a 00 retraction cord was placed initially so Expasyl could penetrate further into the sulcus.

6. The thick viscosity of the Expasyl paste displaces the soft tissue. Expasyl remains in place for 1 to 2 minutes before rinsing. The excellent hemostatic effect eliminates sulcular bleeding, which may lead to voids in critical areas of the final impression.

7. After rinsing, notice how well Expasyl dries the sulcular environment and exposes the margins. A precise impression is virtually assured, which in turn leads to superior-fitting restorations

8. Using Take 1 Super Fast Wash material, the intraoral tip is placed between the retracted tissue and the restorative margin. The material is expressed in front of the tip and moved circumferentially twice around each preparation. The wash viscosity is thixotropic, flowing under pressure to provide excellent detail without dripping. One minute of working time is plenty, even for this four-crown case.

9. Take 1 Super Fast Medium was used in the impression tray. Super Fast's color combinations make impressions easy to read and patients appreciate the peppermint scent. The final impression is free of voids and the subgingival margins are captured in perfect detail.

10. Take 1 Bite creates a precise centric registration record to accurately position the opposing cast in the laboratory with its quick set time and no resistance to closure. When set, its rigidity allows for accurate placement of the working casts for fabrication of the definitive restorations. This allows the dental technician to create accurate occlusion in the restorations that will require minimal to no adjustments.

11. TempBond NE Unidose is used to cement the provisional restoration. The convenience of single-dose dispensing plus the easy cleanup makes it an excellent choice. Properly contoured, the provisional restorations will provide a healthy environment that will nurture the tissues. The control of the sulcular environment is paramount to the success of bonded restorations.

12. OptiBond Solo Plus with Dual Cure Activator allow for predictable bonding of esthetic restorations even if thorough penetration of the curing light is prevented. The fact that OptiBond has always been a filled adhesive means less chance for adhesive failures and postoperative sensitivity.

13. The restorations loaded with Nexus2 resin cement are seated on the preparations. After the gel sets, about 2 minutes, excess cement is easily cleaned. The new dual syringe eliminates hand mixing and ensures the right ratio of base and catalyst with no air bubbles.

14. The completed restorations. The Kerr Family of Crown and Bridge Products form a solid foundation for successful and long-lasting dental reconstructions.

Final preparation for a belleGlass HP crown.

Bend the tip to facilitate extrusion. Being quite viscous, Expasyl holds its rigidity after being placed into the sulcus.

Extrude Expasyl slowly into the sulcus. Keep the tip angled toward the long axis of the tooth.

To obtain adequate retraction, place enough paste to totally fill the sulcus.

Leave Expasyl in the sulcus 1-2 minutes, then thoroughly rinse with an air/water spray.

The final impression, exhibiting an accurate replication of the intricate marginal area.

Crown preparation. Note the crevicular bleeding.

Expasyl is applied, completely filling the sulcus. Note the dry, compact appearance.

The paste is thoroughly rinsed, leaving the sulcus dry, open and ready to take the impression.

Final preparation. Dr. Terry prefers to place a single strand of retraction cord prior to using Expasyl, which is optional.

Apply Expasyl slowly into sulcus. Place enough paste to fill the sulcus.

Leave Expasyl in the sulcus 1-2 minutes, then thoroughly rinse with an air/water spray. Sulcus is now ready to accept final restoration.

Crown is seated and excess cement is being removed with a brush.