Restoring Pit and Fissure Caries with a Flowable Hybrid

A young female patient arrived at the dental office with pit and fissure caries in teeth # 20 and 21 (Fig 1). After discussing it with the patient. the treatment plan was to restore the lesions with Tetric EvoFlow flowable hybrid composite from Ivoclar Vivadent.

Fig. 1. Pre-operative situation: Pit and fissure caries in teeth # 34 and 35

After brief cleaning, the tooth shade was determined while the teeth were still moist. OptraDam (Ivoclar Vivadent) rubber dam was placed to ensure a dry operating field (Figs 2 to 4).

Fig. 2. OptraDam, rubber band and rubber dam punch

Fig. 3. OptraDam in place

Fig. 4. Occlusal view of teeth # 34 and 35 prior to preparation

Next, the carious lesions were removed preserving as much tooth structure as possible. The cavities were rinsed with water spray and then dried (Fig 5).

Following this, the prepared teeth were conditioned with 37 % phosphoric acid using the total-etch technique (Figs 6 and 7). Then Excite (Ivoclar Vivadent) light-curing single-component dentin/enamel adhesive was applied (Fig 8).

Fig. 5. Teeth # 34 and 35 after removal of carious tissue

Subsequently, the selected shade of Tetric EvoFlow was applied to the cavities using Cavifils. The restorations were pre-contoured with a small condenser and then light-cured (Fig 9 to 11).

After light-polymerization, fine-grit diamonds were used to finish the restorations and polishing was performed with an Astrobrush polisher (Ivoclar Vivadent).

After removal of the rubber dam, the occlusion was verified and fluoride was applied topically to the teeth (Figs 12 and 13).