Dr. Sushil Koirala articulated his clinical philosophy in the foreword to his book, A Clinical Guide to Direct Cosmetic Restorations with Giomer:
"I diligently record all my cases and with the advances in digital photography, I have been able to view them in high magnification. This has helped me immensely to improve on my aesthetic work, modify treatment plans and choose suitable materials for each clinical scenario considering the patient's health, function, and smile aesthetics.
Aesthetic dentistry is considered a form of art which requires vision to express possibilities and skill to meet the demands of the patient. Perfection in aesthetic restorations cannot be achieved without unstinted dedication, commitment, and passion toward the profession. We should also keep abreast of new trends and continue to enhance knowledge of treatment options in terms of principles, procedures, materials, and the latest techniques."
A patient presented with unsightly direct composite restorations on both centrals. Replacement with Beautifil II restorative from Shofu was treatment planned. Here's the case, courtesy of Drs. Koirala and Adrian Yap.
The problem with this patient's existing composites is obvious from the facial.....
...and the lingual.
The existing restorations were removed.
The new restorative design was outlined with beveling.
A self-etching primer was applied....
...followed by the bonding agent.
The initial build-up with Beautifill II Giomer restorative....
...was contoured with a diamond point.
The second tooth was etched.....
...and bonding agent was placed.
A flowable "frame" was created with Beautifil Flow F10.
Here's the flowable "frame" before build-up.
After isolation Beautifil II is again used for the build-up.
The dentin shape is created....
...and the enamel built-up.
Contouring is accomplished with a diamond point.
The proximal surface is adjusted with a Super-Snap coarse disk .
A OneGloss midi point is used for finishing and polishing.
The Compomaster is used to acheive a high final shine.
Here are the restorations 1 week post-op.