Clinical Case Report: Restoring a Lower Molar with SDI Stela Composite During Active Aligner Treatment
Dr Dan Shaffer BDS RDT PGCertDentLaw
Abstract
This case report demonstrates the successful use of SDI Stela composite resin to restore a fractured amalgam filling on a lower molar tooth during ongoing Active Aligners orthodontic treatment. By utilising the patient’s aligner as a template, we ensured the restoration met the required occlusal and morphological criteria. This approach allowed uninterrupted aligner therapy while addressing the patient’s restorative needs effectively.
Introduction
Patients undergoing clear aligner therapy often present with concurrent restorative needs, such as managing fractured fillings. Ensuring that restorative treatment does not compromise aligner fit or progress is critical to maintaining the continuity of orthodontic therapy. In this case, SDI Stela composite was selected for its excellent handling properties, high strength, and natural aesthetics. The aligner served as a functional template, enabling precise contouring of the composite to ensure compatibility with the aligner’s fit and function.
Case Presentation
Patient History:
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A 34-year-old patient presented with a non- carious fractured amalgam filling on the lower left first molar (tooth 36) during Active Aligners treatment.
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The patient was midway through a 20-stage aligner series for mild to moderate crowding.
Clinical Assessment:
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Fractured amalgam with exposed dentin with no caries or pulpal involvement.
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The aligner for stage 11 exhibited a proper fit, indicating good progress in treatment.
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Radiographic analysis confirmed no underlying pathology or primary dental disease.
Treatment Objectives
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Restore tooth 36 with a durable, aesthetic material.
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Ensure the restoration does not disrupt the aligner’s fit or progression.
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Minimise interruptions to the patient’s aligner therapy.
Materials and Methods
Materials Used:
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SDI Stela composite resin (A/ A3 shade)
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SDI Stela Primer
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Patient’s stage 11 Active Aligner
Procedure:
1. Isolation and Preparation:
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The amalgam filling and any secondary decay was investigated thoroughly, leaving sound dentin and enamel.
2. Primer Application:
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The cavity was rinsed and dried gently.
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SDI Stela primer was applied, gently air-thinned, and left to dry for 5 seconds.
3. Composite Placement:
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The SDI Stela composite (Stela capsule) was placed.
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The aligner was used as a template to shape the occlusal and buccal anatomy. It was seated gently over the uncured composite to ensure precise contouring and alignment.
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The aligner was left in situ for three minutes.
3. Composite Placement:
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The SDI Stela composite (Stela capsule) was placed.
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The aligner was used as a template to shape the occlusal and buccal anatomy. It was seated gently over the uncured composite to ensure precise contouring and alignment.
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The aligner was left in situ for three minutes.
4. Finishing and Polishing:
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The aligner was removed, and the restoration was refined with fine-grit burs,polishing discs and rubber polishers to achieve optimal shape and surface finish.
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The aligner was re-seated to confirm fit and compatibility.
5. Postoperative Instructions:
The patient was advised to resume regular aligner wear immediately.
The patient was advised that after the aligner treatment ends, she should decide if she would prefer to crown the tooth.
Results
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The SDI Stela composite restoration provided an excellent seal, strength, and aesthetic match with adjacent dentition.
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The aligner fit was maintained without any adjustments, allowing the orthodontic treatment to continue as planned.
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At a one-month follow-up, the restoration showed no signs of wear or failure, and aligner progress was on schedule.
Discussion
The use of SDI Stela composite in this case highlights its suitability for managing restorative challenges during aligner therapy. Its superior handling properties allowed precise contouring using the aligner as a template, ensuring the restoration met functional and aesthetic criteria. The aligner’s dual role as a template and functional orthodontic appliance minimised treatment interruptions and enhanced patient satisfaction.
This case also underscores the importance of selecting materials with high wear resistance and compatibility with clear aligners. SDI Stela’s blend of strength and aesthetics makes it a valuable option in similar clinical scenarios.
Conclusion
This case demonstrates that fractured restorations can be managed effectively during aligner therapy using SDI Stela composite and innovative techniques. By leveraging the aligner as a template, clinicians can ensure restorative precision without compromising orthodontic progress. This approach highlights the seamless integration of restorative and orthodontic care to achieve optimal patient outcomes.
References
- SDI Limited. (n.d.). Stela Composite Resin: Product Specifications. Retrieved from SDI website.
- Sheridan, J. J. (1997). "The Essix appliance: Esthetics and beyond." Journal of Clinical Orthodontics, 31(4), 258-267.
- Sachdeva, R. C., et al. (2020). "Managing restorative challenges during aligner therapy." Orthodontic Practice Journal, 11(3), 45-51.
