Marketplace272 www.dentistry.co.ukanniversary issue 2015

Composite dentistry with the Bioclear technique and the David Clark matrixDominic Hassall and Claire Burgess share their experience with a revolutionary composite placement technique and matrix system achieving consistent, long-lasting aesthetics in anterior and posterior composite restorations

With increasing aesthetic demands from patients, the loss of soft tissue, particularly in the interdental papilla, can be a major concern for patients and can occur due to a number of factors, including post non-surgical periodontal therapy or orthodontic treatment. This clinical situation is often termed ‘black triangle disease‘ (Figure 1).

The repair of papilla defects using periodontal techniques is unpredictable and restorative management of black triangle disease with traditional matrix systems and composite techniques has previously proved a challenge for the clinician potentially resulting in:• Poorly contoured restorations• Gingival overhangs compromising the periodontal condition• White lines and poor blending with the natural tooth• Early staining of the restoration.

New techniquesThese problems have been addressed with the development of the Bioclear composite placement technique used in conjunction with the David Clark matrix system.

Clinically, the technique involves the use of specifically anatomically shaped matrices shaped for particular teeth (Figures 2, 3 and 4) and heated composite is essentially

Figure 4: Anatomically shaped David Clark matrices in situ

Figure 2: Diastema closure matrix

Figure 3: Anterior composite matrix

Figure 1: Black triangle disease between the UL1 and UL2 in a high risk papilla case

These problems have been addressed with the development of the Bioclear composite placement technique

Dominic Hassall BDS MSc (Manc) FDS RCPS (Glasg) MRD RCS (Edin) FDS Rest Dent (Eng) is director of Dominic Hassall Training Institute and associate clinical professor of restorative and aesthetic dentistry at the University of Warwick,

president of the British Academy Aesthetic Restorative and Implant Dentistry (BAARID). He is a General Dental Council registered restorative, prosthodontic and periodontal specialist.

Claire Burgess BDS MFGDP RCS (Eng) MSc (Res Cos Dent) UCLAN graduated from Birmingham University in 1999. Since then she has lived and worked in the area as an associate in general practice.

Claire was a finalist in the restorative category of the National Smile Awards in 2010 and 2011 – the only dentist in the west Midlands to have been a finalist two years running. She also lectures in anterior and posterior composite restorations on the contemporary restorative and cosmetic dentistry course, and is a clinical tutor at Warwick University lecturing on the restorative MSc.

Marketplace273anniversary issue 2015www.dentistry.co.uk

injection moulded. This is combined with a polishing system that results in highly aesthetic blended, anatomically shaped composites, with no overhangs and excellent long-term resistance to staining (Figure 5).

The technique was first described in the UK by Morby, Burgess and Hassall in the International Journal of Advanced Clinical Dentistry, the official journal of the British Academy of Aesthetic Restorative and Implant Dentistry (BAARID).The technique is also invaluable for:• Diastema closure• Anterior and posterior composite restorations• Direct composite veneers• Direct composite crowns particularly on peg-shaped laterals• Direct composite onlays. The system provides a highly cost- effective and durable treatment option for patients.

Clinical caseThis clinical case (shown in Figures 1-5) demonstrates a ‘high-risk papilla’ with a triangular shaped lateral incisor and elongated interdental papilla, where a black triangle developed between the UL1 and UL2 post non-surgical periodontal therapy. The system ensured excellent interproximal emergence with no gingival overhangs, tight contact points and an excellent aesthetic outcome for the patient.

The Dominic Hassall Training Institute is the UK’s only approved international training centre for the Bioclear technique and David Clark matrix system. It features in the institute’s restorative aesthetic, operative and composite courses with extensive hands-on practical sessions allowing you to introduce the techniques and systems into your practice.

Figure 5: Black triangle eliminated with excellent contouring and aesthetics

This clinical case demonstrates a ‘high-risk papilla’ with a triangular shaped lateral incisor and elongated interdental papilla

Enquiries:0121 705 2705 www.dominic-hassall-training.co.uk

Dominic Hassall BDS MSc (Manc) FDS RCPS (Glasg) MRD RCS (Edin) FDS Rest Dent (Eng)Registered Restorative, Prosthodontic and Periodontal SpecialistDirector Dominic Hassall Training Institute

President BAARID

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