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CLASS II DIRECT
RESTORATION DIRECT POSTERIORS - CASES - SHADEGUIDES - TIPS AND TRICKS
TWO WAYS OF STAINING POSTERIOR COMPOSITES
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Aesthetic composite restorations in the posterior region means functional composite restorations.
Function=Aesthetic
Creating cusps, groves, slopes in your restoration is not a trend or a “cool” way of doing composite
restorations but a must have procedure for a functional restoration.
More often dentists use brown stains to give a more natural looking restoration in the posterior
SHOP region. The question is - this is mandatory for a aesthetic posterior restoration?
The beauty is in the eye of the beholder, this is why sometimes the patients appreciate to be
beautiful and natural and more often they complain about unpleasant brown spots on their
restoration. On the other hand dentists are very happy and exciting with brown stains on composites
in the posterior region.

The staining procedure itself is not a label or a certificate for an aesthetic and correct composite
posterior restoration. In my opinion staining procedure define and enhance the 3D perception of the
occlusal morphology. As a perception for the patients very often they appreciate the detailed work (if
the doctor explain why he used the stains) and also the different way of doing a posterior composite
restoration.
The intensity of the brown should be chosen very carefully regarding to the natural stained adjacent
or homologue teeth.
If the stain and morphology copy of the natural teeth is good, the unpleasant perception of the
patient disappear because the restoration is integrated into the arch. More often the patients
CASES OF THE WEEK complain if the intensity of the stain is bigger than the neighbours and less complains when the stain
procedure is more delicate.
In this article two ways of staining procedure is described:
JAN 18 TO JAN 24 - staining after the morphology is finished - external staining
- staining during the morphology design
Adam Zawadka
Marc Kaloustian
Marino Sutedjo
Ivan Mirovic
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n1. This technique called also the external stained technique is done after the last layer of composite
or after the contouring procedure. As a step by step procedure - a small quantity of brown stain
TWO WAYS OF STAINING applied at the level of the groves and fissure with a sharp instrument (fine probe, Fissura, 10 k-file,
POSTERIOR COMPOSITES etc) or using a ultra fine needle tip applied directly to the stain syringe - before light curing, the
stain excess is removed with an adhesive tip - if is needed additional layers can be used until the
TESTIMONIALS
desired characterization is obtained

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FOUNDERS
 Walter Devoto
Dr. Walter Devoto Born in
Chiavari on 29/03/1965
graduated in Dentistry in 1991
at Genova University.

The seven is designed. The morphology design is the basement for a natural like brown
characterization.

Angelo Putignano
M.D. degree and D.D.S. post
graduate certificate from
University of Ancona-Italy.

FOUNDERS ENDO

Pio Bertani
Pio Bertani is a full member of
the prestigious association...

Modelling of the composite on the 6 and the 7

Fabio Gorni
Fabio Gorni is an active
member of the Italian Society
of Endodontics and the Italian
Academy...

MEMBERS

Monaldo Saracinelli
I’ve been a student of prof.
Fabio Toffenetti and The aspect of the morphology after the modelling. In this stage I prefer to be more delicate with the
Riccardo Garberoglio.
excess of the material. This fact save me a lot of time for contouring and finishing procedure. Up to
this point I have spent 62 minutes with the patient.(hello, anesthesia, isolation, cavity preparation,
Jordi Manauta adhesion, layering)
Was born in Mexico City,
where he graduated cum
laude. in dentistry from
UNITEC.

Gaetano Paolone
My passion is aesthetic
direct and indirect
adhesive dentistry in
anterior and posterior
teeth.

Daniele Rondoni
Born in Savona in 1961
where he lives and has
 worked in his own
laboratory since...

Vincenzo Musella
Vincenzo Musella
graduated in dental
technician. Proud friend
and student of...

Giuseppe Marchetti
Giuseppe Marchetti was
born in Parma (Italy) in
October of 1972 and
graduated from...

Simone Grandini
Chair of Endodontics and
Restorative Dentistry,
University of Siena, Italy.

Giovanna Orsini
Giovanna Orsini is a well
known researcher in Italy
and internationally.

Paulo Monteiro
My passion for esthetic
dentistry began when I After the layering I have applied a brown stain at the level of the groves. The quantity of the stain at
attended the last year...
this moment it is not so important. To have a very good control of the stain procedure is to apply it on
quite smooth composite surface. This why if the composite surface is too rough first I will do a
Louis Hardan finishing procedure and after that I will stain.
Head of Restorative and
Esthetic department in
Saint-Joseph University
in...

Patrizia Lucchi
Patrizia Lucchi Graduated
in Dentistry cum Laude in
1995 at the University of
Verona

Anna Salat
Dr Anna Salat graduated
with a degree in dentistry
from the International
University of Catalonia…

Giulio Pavolucci
After graduation magna
cum laude in Dentistry, I
started focusing my daily
work on...

Marcos Vargas
Dr. Marcos Vargas
attended Cayetano
Heredia University School
of Dentistry in Lima...

Stefan Koubi
Dr. Koubi graduated from
University of Marseille
where he...
Another way to applied the tint is using a very sharp instrument eg. Fissura from LM Arte

Engin Taviloglu
Dr. Taviloglu graduated
from ?stanbul University
School of Dentistry in...

Dimitar Filtchev
Co-founder of the Laser
Dental Center and the
Implant...

Angie Segatto
My commitment to arts has
determined my
specialisation.

Kilian Molina
Kilian is required as a
regular lecturer in indirect
restorative...

Gregory Camaleonte
I was born in 1980 in
Marseille-France and i have
graduated in 2006 from...

Removing the excess of the stain with a adhesive tip.

Caroline Werkhoven
Caroline Werkhoven
graduated in 2002 at
ACTA, the dental faculty in
Amsterdam..

Ajay Juneja
Ajay Juneja finished his
BDS in the year 1995...

Carlos Fernández
 Villares
Member of SEPES Spanish
Soc...

Sulivan Leite
Sulivan Leite graduated
from the Ribeirao...

Maciej Zarow
Author of book edited by
Quintessence: “Endo-
Prosthodontics: guidelines
for clinical practice” ...

Dan Lazar
Dan Lazar, graduated from
the Faculty of Dentistry in
2005 in Cluj-Napoca...

Murad Akhundov
Dr. Murad Akhundov
graduated from the
Faculty of Dentistry in
Baku...

Janos Grosz
Graduated summa cum The aspect after staining procedure before finishing and polishing.
laude in 2006 from the
University of Szeged,
Faculty of Dentistry,
Hungary...

MEMBERS ENDO

Simone Grandini
Chair of Endodontics and
Restorative Dentistry,
University of Siena, Italy.

Louis Hardan
Head of Restorative and
Esthetic department in
Saint-Joseph University
in...

Filippo Cardinali
Graduate in Dentistry and
Dental Prostheses at the
University of Ancona in
1992. Active Member of...

Riccardo Tonini After finishing, polishing and occlusal check. The final TIME after polishing is 95 minutes.
He is active member of the
Italian Academy of
microscopic Dentistry and
Active member of...

Paolo Generali
Doctor Generali was
graduated from Pavia
University in the year...

Calogero Bugea
Calogero Bugea, Graduate
in Dentistry, Certificate in
Oral Surgery. Active
Member of the
International
Piezosurgery...
Bojidar Kafelov
Dr. Kafelov has been a
practicing full time
endodontist at the
Svedent Dental Clinic
since...

Clifford Ruddle
Internationally recognized
as a leading expert in all
aspects of clinical
endodontics, Dr. Ruddle is
acclaimed for...

Pierre Machtou
Pierre Machtou was the 2. The SECOND TECHNIQUE that it can be used for staining is during the occlusal morphology design.
first scientific director and
general secretary of the The initial aspect of the case.
French Endodontic
society...

Marga Ree
Primary author of several
articles published in
national and international
journals and has ...

Carlos Aznar Portoles

Dr. Aznar holds his
exclusive endodontic
practice in Santpoort-Zuid
and Amsterdam where...

Marco Martignoni
Marco Martignoni leads a
private clinic in Rome Italy
and dedicates his practice
 mainly to endodontics,
pre-prosthetic...
Massimo Giovarruscio
Massimo Giovarruscio
works in Rome, Bristol and
London, specialising in
Endodontic Treatment
and...

The aspect of cavity preparation

As a preparation for staining procedure I reconstruct first the vestibular part of the cavity.

A small quantity of the stain is applied on the BASE( into the cavity) of the vestibular cusp. BEFORE
light curing the stain I have applied the composite for the oral cusp. Pushing the composite against
the cured vestibular cusp the stain will flow up to the surface, following the groves and fissures.
Also as in the first technique with an adhesive tip, the excess of the stain can be removed. A very
natural aspect can be achieved with this technique. The aspect after the last layer.

The same technique for the second molar. The vestibular cusps are already designed and the stain
that is NOT light cured placed at the base of the cavity.

One of the oral cusp reconstruct and the appearance of the stain at the surface. The advantage of
this technique is that the stain line is more delicate and well defined.
The disadvantage of this technique is that you are forced to defined very good your morphology.
This why this technique is more operator sensitive.

The final aspect of the restorations after finishing polishing and occlusal check.

The staining procedure is a really need for a posterior composite restoration?

From medical view absolutely not.
Maybe some dentist can say that this is a time loosing procedure. If they feel in this way is better not
to do and I respect that. Yes we can say that we should do everything for the patient but also I think
that we need to do also for ourselves!
I am doing this because I feel more, I create more, I keep the passion in every restoration or at least
time to time. Changing things in your daily practice, even is they are very small, can keep your
passion a long time also for big and important thing!
Csikszentmihalyi, Mihaly (2014). Flow and the Foundations of Positive Psychology: The Collected
Works of Mihaly Csikszentmihalyi. Dordrecht: Springer, 2014. ISBN 978-94-017-9087-1

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