Why Dentists Struggle with Class IV Composite Restorations

Desai: I think with class IV composites, the struggle comes from really understanding what part of the tooth is missing. How do I recreate this structure using a palette of shades, hues, chromas... and then you add some tints into it, and it's very confusing at times.

It's easy to just do one shade and walk away with it, but the beauty and the artistry of using multiple shades and really learning how to integrate them to create a very natural, seamless restoration is profound, and so I've learned over the years, really learning how to mix these different elements and creating a really nice restoration that the patient can utilize and use for even the rest of their life.

In addition to that, I would say, even really learning the correct contours and the shapes of the teeth to match what's adjacent, right? So if you're doing two centrals, you really can have a little bit of more leeway as to how you want to recreate them, but if you're doing a single central, it's difficult. It's difficult to really mimic and mirror that opposing central. So I would say those are probably the two most challenging experiences, probably with class IV restorations.

Desai: I disagree in terms of anterior teeth, right? I think that I always look at how much is missing, what's the patient's diet like, what's their lifestyle?

What's the best restoration we can do for that patient? And honestly, I say this to my patient very vividly and openly, as much as you don't want to redo the tooth, my goal is to never see that tooth ever again.

Desai: I still remember I was at an AACD workshop, taking Newton Fahl's course, and I had an array of shades, and I had no idea... what's opacity? hue? chroma? What are these simple words, and how does it take a big play into these different shades that are presented before me?

I remember during covid, I just sat down and I watched some of your webinars you gave to really understand what is value and how does that play effect into these restorations. So that was one element, and learning how to contour and polish correctly that way I can get that nice sheen and mimic adjacent teeth.

Desai: We all started from somewhere. So whatever someone's foundation is, you always pick up a pearl or two from another clinician, right?

If I sat in your workshop, I'm always going to pick up something or a technique that you use that I haven't incorporated.

So for those who feel a little more confident, that's great, I can show you little pearls that work for me, or techniques I've used over the years.

For those who are beginners, you know, just take it easy. Learn the core material. Let's get to know the materials before we get into deep diving and the final polishing contour.

So I think no matter what level you're at, you're going to pick up some pearls from this course.

Desai: I love workshops... I think the real way of learning is getting your hands dirty and really learning the material. So we can lecture about it, we can talk about it, but if you're not applying it right then and there, it's very difficult to adapt and adopt on Monday morning, no doubt.

Hands-on kits are available to purchase when you become a member, allowing you to follow along step-by-step in real time or with the recording. The kit will feature high quality materials provided by Clinician's Choice, like Evanesce which is known for its versatility, polishability, and ability to create lifelike anterior restorations .