The stamp technique for direct restoration in a ICDAS 4 carious lesion: A 4‐year follow‐up

Abstract

Objective This case report described the use of a stamping technique associated with a bulk fill composite to restore an ICDAS 4 carious lesion on a posterior tooth. The 4‐year follow‐up is also presented. Clinical Considerations A 32‐year‐old patient presented a carious lesion on tooth 36 with an underlying dark shadow at the dentin seen from the noncavitated enamel occlusal surface, which was compatible with an ICDAS 4 carious lesion. The lesion was radiographically detected and the caries disease was treated with dietary and hygiene habits orientations. Before accessing the lesion and selectively removing the carious tissue, an occlusal stamp was made by applying a flowable resin composite to copy the anatomy of the noncavitated enamel surface. The cavity was restored using a bulk fill resin composite (Opus Bulk Fill, FGM) with 4‐mm‐thick increments. Before curing the last increment, a Teflon band was adapted at the uncured bulk fill composite surface and the occlusal stamp made with the flowable composite was pressed against it to reproduce the natural characteristics and initial occlusal anatomy. The top surface was light‐activated for 40 s. After 4 years, small wear could be seen in the restoration, but still within clinically acceptable levels. Conclusion The occlusal stamp technique allows reproduction of the natural anatomy of teeth affected by ICDAS 4 carious lesions with good clinical longevity over 4 years. Clinical Significance This case report presents the use of the stamp technique to restore a tooth affected by an ICDAS 4 lesion, in which a carious process reached the dentin and the enamel anatomy was still preserved. The bulk fill resin composite associated with the occlusal stamp was chosen to quickly restore the cavity with clinical predictability. Bulk fill composites allow the insertion of up to 4‐mm‐thick increments and offer lower shrinkage stress, good clinical longevity and a less time‐consuming procedure in cases of posterior teeth, especially if associated with the stamp technique.

Perfecting Posterior Dental Simulacrum: Unveiling the Stamp Technique for Tooth Restoration

“…According to Vertuan et al, at four years of follow-up, small wear could be seen in the restoration, which was undertaken using the stamp technique. However, this wear was still within clinically acceptable levels [3]. According to Ramseyer et al, seven patients were assessed, and after a mean observation time of 40 months (40.8 ± 7.2 months), the overall outcome of the restorations was good [12].…”

“…Determining the cusp-fossa connection of teeth in direct composite restoration is complex, and occlusal harmony necessitates a substantial amount of clinical time in addition to operator competence. Final adjustments and polishing take longer than amalgam restoration [2,3]. To combine function and esthetic, Dr. Waseem Riaz presented an alternative approach called the "stamp technique" [4].…”