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Procedure nique helps prevent the risks associated with pulpal ex-
The patient requested a non-amalgam restoration to posures that often occur when trying to establish a totally
restore a second premolar that had an asymptomatic, sound dentin base in the region of the pulp horn.1, 2
deep lesion close to the pulp. Because of the proximity of Working with an Isolite (Isolite Systems), sectional V3
the lesion to the pulp, the option of a closed glass ionomer Tab-Matrices (Triodent) were placed. The appropriate Tri-
cement (GIC) sandwich, composite restoration was cho- odent Wave-Wedges were inserted to adapt the gingival
sen because of the potential remineralization effects asso- margins of the matrices to the cavity margins. The pin-
ciated with GIC placed on deep affected dentin close to tweezer tabs on the occlusal section of the matrices were
the pulp. then bent onto the occlusal surface of the adjacent teeth
The second premolar had an asymptomatic, deep le- to improve visibility. The matrices were stabilized with
sion, close to the pulp. When the decay had been re- molar (green) and premolar (yellow) Triodent V3 separa-
moved, a 2-mm wide dentin periphery was established tor rings and the contact points burnished with a ball bur-
and the decision was made to leave a thin layer of affected nisher (Figure 1). The occlusal surfaces of the V3 Ring
dentin directly over the pulp horn to avoid potential ex- tines have a low profile and sit flush with the occlusal sur-
posure. Auto-cure GIC creates a sound seal to dentin and, faces of the teeth, improving access and visibility.
by successfully isolating the depths of the lesion, this tech- The closed sandwich restoration technique—a layer of
GIC completely encased by composite on the occlusal and
Graeme Milicich, BDS interproximal surfaces—was chosen to provide a sound,
Private Practice impermeable seal to isolate the deep, affected dentin. Fuji
Hamilton, New Zealand
IX GP Extra (GC America, Inc) was used to replace the
E-mail: gwmilicich@xtra.co.nz
Web site: www.advancedental-ltd.com lost deep dentin and to layer this, with Gradia Direct (GC
America, Inc), bonding the 2 layers of the restoration with