Operative II: Indications and Contraindications (Reading)

Class I, II, III, IV, V, and VI restorations

Indication

Foundations and core buildups

Indication

Sealants and preventive resin restorations (conservative composite

restorations)

Indication

Esthetic enhancement procedures:

-Partial veneers

-Full veneers

-Tooth contour modifications

-Diastema closures

Indication

Temporary or provisional restorations

Indication

Periodontal splinting

Indication

Luting of indirect esthetic restorations (when used in flowable

form, or when heated to increase flow)

Indication

Inability to obtain adequate isolation

Contraindication

Occlusal considerations related to wear and fracture of the composite material

Contraindication

Extension of the restoration on root surface

Contraindication

Operator factors

Contraindication

Q: What is a primary contraindication for use of direct composites related to the operating site?

A: If the operating site cannot be isolated from contamination by oral fluids, composite (or any other bonded material) should not be used.

Q: When might composite not be the choice due to occlusion considerations?

A: If all of the occlusion is on the restorative material, composite may not be the choice for use particularly in patients with heavy occlusal function;

however, the need to strengthen remaining weakened unprepared tooth structure with an economical composite restoration procedure (compared with an indirect restoration) and the commitment to recall the patient routinely and in a timely manner may override any concern about excessive wear potential.

Q: What is a contraindication related to the extension of the restoration?

A: Any restoration that extends onto the root surface may result in less than ideal marginal integrity.

Q: What operator factors can contraindicate the use of direct composites?

A: The operator must be committed to pursuing procedures, such as tooth isolation, that make bonded restorations successful. These additional procedures may make successful bonded restorations more difficult and time consuming to achieve.