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| Overview |
| In contemporary dentistry, aesthetic and functional restorations have increasingly replaced traditional amalgam fillings, especially in posterior teeth. The stamp technique, introduced by Dr. Waseem Riaz, combines biomimetic principles with practical efficiency, enabling dentists to replicate the morphology and occlusion of teeth accurately. This case study explores the application of the stamp technique in restoring a carious tooth while preserving healthy tooth structure. |
| Case Presentation |
| A 25-year-old female patient presented with a chief complaint of black stains on her mandibular right first molar (tooth number 46) that had been evident for three months. Her medical history was unremarkable. |
| Clinical Examination |
| An intraoral examination revealed occlusal caries classified as ICDAS code 4, with visible dentin through the enamel, indicating significant decay. Electric pulp testing showed an early response (reading 7) in tooth 46 compared to a reading of 21 in the contralateral tooth, suggesting partial pulp vitality. A hot gutta-percha test yielded no lingering pain, and periapical radiographs confirmed radiolucency limited to enamel and dentin without pulp involvement. No marginal ridge loss was noted, making the tooth a suitable candidate for restoration using the stamp technique. |
| Procedure |
| Isolation: |
| A flowable composite material was applied to the intact occlusal surface of the tooth. A micro-brush, modified for handling, was submerged in the composite and light-cured, creating a negative impression of the occlusal topography. |
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| Cavity Preparation: |
| Caries were excavated thoroughly using an air rotor handpiece with a tungsten carbide bur, achieving a Class I cavity. |
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| Etching and Bonding: |
| The cavity was etched for 30 seconds with 37% orthophosphoric acid, rinsed for 15-20 seconds, and air-dried. A bonding agent was then applied with an applicator tip and cured for 20 seconds. |
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| Etching with 37% orthophosphoric acid in tooth number 46 |
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Bonding agent application
in tooth number 46 |
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| Restoration: |
| The composite restoration was placed incrementally, building up to approximately 1 mm below the occlusal surface. A Teflon sheet was laid over the final increment to prevent oxygen inhibition during curing, facilitating a smooth surface finish. The fabricated occlusal stamp was then gently pressed against the Teflon sheet to achieve an accurate occlusal anatomy. |
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| Finishing and Polishing: |
| Excess composite material was trimmed away using sharp instruments, and the restoration was light-cured. After removing the Teflon sheet, finishing was performed with a polishing paper disc. Articulating paper was used to check for occlusal contacts, ensuring proper function. |
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A post-operative photograph of
tooth number 46 |
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| Post-Operative Instructions |
| The patient was advised to avoid hard or sticky foods for 24 hours and to maintain regular oral hygiene practices, including gentle brushing and flossing around the restored area. |
| Discussion |
| The stamp technique offers significant advantages over traditional manual composite restoration methods. It accurately replicates occlusal anatomy, reducing the likelihood of occlusal discrepancies that could lead to patient discomfort or craniomandibular disorders. The use of a Teflon sheet during curing mitigates issues with oxygen inhibition, leading to better surface quality and reduced porosity in the final restoration. |
| Additionally, this technique minimizes chair time and material waste, making it both cost-effective and efficient for dental practitioners. The ability to preserve healthy tooth structure while restoring function and aesthetics aligns with the principles of biomimetic dentistry, which seeks to mimic natural tooth anatomy. |
| Limitations |
| While the stamp technique demonstrates many benefits, potential drawbacks include the susceptibility of the stamp to breakage and the cost of materials such as flowable composite and micro-brushes. Successful implementation also requires expertise and clinical judgment, and it may not be suitable for teeth with extensive carious damage. |
| Conclusion |
| The stamp technique represents a significant advancement in biomimetic dentistry, offering an efficient and effective method for restoring posterior teeth. This case illustrates its application in managing carious lesions while maintaining intact tooth structure, underscoring its benefits in clinical practice. As the field of dentistry continues to evolve, techniques like the stamp method pave the way for improved patient outcomes and enhanced aesthetic restorations. |
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| GGI-CO-A1-AQS-300032384-ELC-I24-1518 |
| Reference: |
| 1. |
Saoji SS, Ikhar A, Manik K, Awghad S, Panchal S. Elevating Restorative Dentistry: Use of the Art of Stamp Techniques in Mandibular Posterior Regions. Cureus. 2024 Jul 7;16(7):e64014. doi: 10.7759/cureus.64014. PMID: 39114196; PMCID: PMC11304413. |
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