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Composite White Lines

by Dr. David Clark Feb 03, 2014 Aesthetics Not tagged yet...

Is there anyway to prevent those lines in the composite?  That is where I did 3 separate increments and cured each one.  One in the chamber, one in the box, and one for the occlusal.  I hate the look of that on an otherwise good case.  The composite is luxacore, if that matters.

-Jeff

 

David-

This is a case of wrong conversations.  Well intentioned but misdirected.  

 There is a big problem with "seaming" when traditional  composite is layered and in addition these boxes have terrible C-factor.  The best solution is Filtek Bulk Fill Flowable.  It has low stress, can be put down in 4 mm increments, and won't have the terrible gaps that form with layering with more viscous composites.  It's the best low stress bulk fill.  An excellent dentin replacement.  Then a final 2mm "helmet" of paste can be injected on top.  If you heat the composite and "wet" the interface with air-thinned adhesive you shouldn't end up with a seam there either.  Onlay the cusps on case like this and you have a 10 year tooth.   
Remember that an intracoronal composite like the one shown here is no better than amalgam at preventing cuspal fracture.  So yes the dentin truss is a huge asset but still not enough to prevent cuspal fracture, and when not if the MB cusp snaps off at bone level people may discount the value of your brilliant dual access. 
Using core paste fixes the depth of cure problem but they have relatively high curing stress and are more prone to micro and macro voids than flowable.  Regular flowable has poor depth of cure and high shrinkage and high curing stress, and iffy radiopacity

 

 Layering doesn't fix bad C-factor.  You need Low Stress composite.  This stuff works under the microscope.  It doesn't leak and there is no white line (Filtek Bulk Fill Flow)  I don't use core paste.  Amalgam is better than core paste.  

 

Fiddling with light curing Pulse/flash hasn't been show to provide better outcomes.  It's just more errant conversation

 

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