Replacing compromised older restorations is a common procedure in operative dentistry. A new restoration has to fit the residual tooth structure cleanly, blend with the surrounding dentition, and hold up to occlusal load for years. In this case, Dr. Gaetano Paolone demonstrates a step-by-step protocol for replacing compromised older restorations using Transcend™ universal composite. “Transcend composite adapts chromatically to the substrate and maintains its shape during molding,” says Dr. Paolone.

Step by Step

1. Compromised older restorations.

The patient presented with compromised older restorations in need of replacement.

2. Isolation and removal of older material.

After proper rubber dam isolation, the older restorative material was removed.

3. Selective enamel etch.

The enamel was selectively etched with Ultra-Etch™ etchant for 30 seconds.

4. After the bonding procedure.

Clinical situation after the bonding procedure.

5. Incremental placement of the Universal Body shade.

Transcend™ composite Universal Body (UB) shade was applied incrementally in 2 mm portions.

6. Before occlusal characterization.

Clinical situation before occlusal characterization.

7. Occlusal characterization with pigment.

Enhanced occlusal characterization is visible after the application of pigment.

8. Final polished restoration.

Final restoration after the polishing protocol.

What Clinicians Are Saying

“The Universal Body shade has amazing chameleon-like properties and doesn’t require a blocker. I use it for the vast majority of my fillings. For those demanding cosmetic situations, the simple dentin and enamel shades allow for layering and give incredible results. Another home run product for Ultradent.”

— Dr. Gary Findley, General Dentistry Advisor, Ultradent

“Transcend is a high-quality, no-compromise material that is a true universal shade-matching composite resin. It will become the workhorse product for your posterior composites, Class Vs, and many anterior restorations. It provides a high-quality result in a timely and cost-effective manner with excellent shade matching.”

— Dr. Mark Pettit, General Dentistry Advisor, Ultradent

“Transcend has been an exciting addition to my daily clinical practice. We all want our dentistry to look as natural and as esthetic as possible while providing high-quality, long-lasting results. Transcend makes it quick and easy to match the shade for my patients. Transcend not only improves the final result but it also saves time and reduces stress because I can feel confident my shade match is going to be great!”

— Dr. Brett Richins, Clinical Affairs Director, Ultradent

“I have been amazed at the beautiful case outcomes with just a single shade. With the Universal Body shade plus the dentin and enamel shades, I can cover about 90 percent of my cases.”

— Dr. Jaleena Fischer-Jessop, Chief Clinical Officer, Ultradent

About Dr. Gaetano Paolone

Since 2014, Dr. Paolone has been a Research Professor in Restorative Dentistry at Università Vita-Salute San Raffaele in Milan. He earned a PhD in Dental Biomaterials from Portsmouth University, UK. Dr. Paolone is an Associate Member of the American Academy of Restorative Dentistry (AARD) and an Active Member of the Italian Academy of Conservative and Restorative Dentistry (AIC). He served on the AIC board as Secretary from 2018 to 2019 and on its Scientific Committee from 2020 to 2022. Dr. Paolone manages a private practice in Rome. He lectures in the master’s program in Esthetics and Restorative Dentistry at the University of Bologna, Italy, and in the Diploma of University (DU) in Esthetic Dentistry at Montpellier University, France. He is the author of two books, Direct Posterior Composite Restorations and Direct Anterior Composite Restorations, and has authored or co-authored numerous articles in international scientific journals and contributed to various textbooks. He regularly lectures at national and international courses and conferences.