We hear why Dr Giovanni Martino uses the ‘Stamp Technique’ and why it works durable, natural-looking fillings.
The demand for aesthetically pleasing dental restorations has escalated in an age dominated by social media and technological advancements. Patients are now looking for esthetically superior dental fillings that blend seamlessly with their natural teeth while providing the necessary functionality.
Direct composite restorations that effectively use the augmentative technique will meet these expectations, but may present challenges. They are time-consuming and technique-sensitive, and the results are often unpredictable.
This traditional approach requires meticulous manual dexterity and often leads to difficulties managing the occlusion after application. Obstructive readjustments may occur once the elastic barrier is removed, which can lead to patient discomfort and dissatisfaction in both the short and long term.
Polymerization shrinkage, a characteristic of composite materials, is also a major obstacle during placement.
Contraction of the composite resin during the curing process leads to stress accumulation, possibly resulting in marginal leakage, microleakage and recurrent caries, if present.
In addition, achieving a perfect occlusal and cusp-fossa relationship requires a high level of skill on the part of dentists, contributing to increased chairside time and complications in achieving optimal contours.
Efficiency and longevity
Furthermore, despite efforts to perfect surface finishes with abrasives, the smoothness achieved often falls short of expectations set by restorations placed under dies.
Matrices help shape the proximal surfaces, but cannot be applied to occlusal surfaces, resulting in the risk of uneven restorations.
These challenges hinder the effectiveness and longevity of direct composite restorations, which warrants a reevaluation of techniques and methodologies.
Caries or tooth decay is a multifaceted condition that erodes the inorganic and organic components of a tooth. This chronic condition is rooted in cariogenic bacteria, which produce acidic byproducts through their metabolic activity on dietary sugars. Over time, these acids begin a descaling process, progressively eroding the tooth structure.
The causative agents of dental caries, mainly Streptococcus mutans and Lactobacillus species, thrive on fermentable carbohydrates in our diet. Their action creates an acidic environment within the dental plaque, paving the way for enamel desalination and eventual cavity formation.
Efforts to combat caries and improve immediate restorative techniques require a comprehensive understanding of the etiology of the disease and the complexities of restoration.
Addressing the limitations inherent in direct composite restorations requires innovative approaches that prioritize functional integrity and esthetic outcomes.
Unrivaled accuracy
Enter the ‘Stamp Technique’ for posterior composite restorations. This is a method designed to reproduce the occlusal anatomy with unparalleled accuracy.
It presents a promising solution for achieving near-perfect duplication of tooth anatomy – whether you are working on a virgin tooth or one that has undergone previous restorations. Its application also extends to cases where the occlusal surface is affected by cavities, which justifies an indirect approach for restoration.
The Stamping Technique, when performed skillfully, greatly assists dentists. It ensures the creation of durable, natural-looking fillings and streamlines the restorative process – meeting the evolving demands of modern dentistry and offering patients the results they expect.
Recommended by Dr Giovanni Martino, a dentist based in Bristol, the Stamp Technique offers accurate occlusal replication for immediate composite resin restorations.
This method involves creating an index that reflects the anatomy of the unprepared tooth, which is then used to press the final composite augmentation prior to hardening.
The technique is suitable for intact occlusal surfaces in Class I and Class II preparations, using matrices for proximal lesions and wax block for cavity lesions. This approach ensures accurate reproduction of the original occlusal anatomy, minimal finishing, and optimal polymerization, using light-cured composite, acrylic resin, and silicone molds.
In this case study below, direct composite restorations using the Stamp Technique were performed using putty.
Case study
The case involved a 29-year-old woman with caries in the Class 1 area of the upper right tooth number 6. After clinical and radiographic diagnosis, the tooth was isolated with an elastic barrier to control moisture. The tooth surface impression was taken using putty, a technique used to ensure accuracy and reliability.
Dr. Giovanni Martino emphasized the importance of this method, which involves taking impressions of adjacent teeth as reference points for insertion, enhancing the accuracy of the procedure.
He explained: “After removing the decay using quick and slow handpieces, the cavity was disinfected using high-concentration chlorhexidine gel for 30 seconds.
“Application followed the VOCO protocol for self-adhesive dentistry, which included etching the enamel with 37% orthophosphoric acid for 15 seconds, selective bonding using disposable cells, blowing air to remove excess bond, and light curing for 20 seconds .
“The application of composite layering was instrumental in reducing microshrinkage and post-operative sensitivity. In this particular case, the selected composite is VOCO Admira Fusion 5, shade A1. The last millimeter of the composite, heated to 60 degrees, was gently applied to the surface of the cavity. Pressure was gently applied to the tooth using the putty wrench and then the excess composite material was removed. A subsequent 20-second light cure was performed, followed by polishing.’
VOCO FINALTOUCH color composites to add additional anatomical features to the tooth, providing the final esthetic touches to the complete restoration.
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Dr Giovanni Martino is a dental associate at Somerford House Dental Clinic and Sleep Lane Dental. He graduated in 2017 with a degree in dentistry from the University of L’Aquila. He has a special interest in orthodontics and restorative dentistry, which he has perfected throughout his extensive training.
