Assoc. Prof. Bora Korkut talks about Class IV restorations, which are some of the most challenging restorative procedures.
Dr. Korkut graduated from Marmara University, Faculty of Dentistry in 2008. He had the ‚Ph.D.‘ title in Conservative Dentistry and ‚Specialist‘ title in Restorative Dentistry fields in 2015. He has been working as an academic member as an Associate Professor at Marmara University, Dentistry Faculty, Department of Restorative Dentistry.
He has many international and national researches and publications about direct aesthetic restorations, tooth wear, tooth bleaching, CAD/CAM restorations, dental magnification, and early diagnosis of caries lesions. He has given many international and national lectures and courses about ‘Direct Anterior and Posterior Aesthetic Restorations, ‚CAD/CAM restorations’, ‘Pre-restorative Approaches’, ‘Dental Photography’ and ‘Tooth Bleaching’ since 2012.
Dr. Korkut is the author of the ‘Esthetic Anterior Composite Restorations’ book published by Quintessence Publishing Deutschland in 2025. It was translated in Turkish, Portuguese, and Chinese. He is a member of the Bio-Emulation Group and ‚GC Europe Restorative Advisory Board‘.
Introduction
Class IV restorations, which involve the repair of fractures or decay in the anterior teeth, are some of the most challenging restorative procedures in dentistry. Since these restorations are visible when a person smiles, aesthetics play a crucial role alongside function. A successful Class IV restoration must seamlessly integrate with the patient‘s natural dentition, replicating not only the tooth‘s colour but also its translucency, texture, and light reflective properties. This level of esthetic integration is essential for patient satisfaction and confidence, as anterior restorations are immediately noticeable. In addition to esthetics, the restorative material must provide strength and durability. Anterior teeth are subjected to significant biting forces, especially on the incisal edges. Composite resins, which can be applied in layers, allow the dentist to replicate the tooth’s natural layers of enamel and dentin, achieving a blend of strength and beauty. Through careful layering and shaping, clinicians can create lifelike restorations that are not only durable but also indistinguishable from the patient’s natural teeth. This combination of esthetics and strength makes composites an ideal choice for Class IV restorations in the anterior segment, where both appearance and functionality are paramount.
1. Initial view
Initial view of an old crown fracture restoration.
2. Shade selection
Composite shade selection with cross-polarization filter photography technique (G-ænial A’CHORD AO2, A1 and JE
shades are selected).
3. Restoration preparation
Removal of old composite restorations and 45° of beveling on the fracture line. Split-dam was preferred as the restoration was not directly related to the gingiva. Then the adhesive protocol was applied by selective enamel
etching and bonding agent application (G-Premio Bond).
4. Split-dam isolation
Split dam isolation followed by using a silicone index shell as base for the build-up of the palatal shell using G-aenial A‘CHORD JE.
The shell was produced on the index as a thin layer using the GC Composite Brush and GC Modeling Liquid, transferred into the mouth, and cured with the D-Light Pro.
5. Placement of metal matrix band
Inter-dental placement of the pre-contoured metal matrix band and producing the interproximal wall using the G-ænial A‘CHORD A1 shade. Then curing with the D-Light Pro.
6. Shaping mamelon effects
Placement of the G-ænial A‘CHORD AO2 shade at the deepest point of the fracture line to improve the masking ability of the restoration. Then curing with the D-Light Pro.
7. Improve masking ability
Placement of the G-ænial A‘CHORD A1 shade above the AO2 shade and shaping the incisal mamelon effects according to the reference tooth (the adjacent central incisor). Then curing with the D-Light Pro.
8. Additive surface layering
Additive surface layering using G-ænial A‘CHORD JE shade. Surface morphology was generated using the GC Composite Brush and the GC Modeling Liquid. Then curing with the D-Light Pro.
9. Interdental/labial surface finishing
Interdental surface finishing using GC mid-grit (red-band) metal strip. Labial surface finishing using pre-polisher spiral wheel (DIACOMP® PLUS RA, EVE).
10. Interdental/labial surface polishing
Interdental surface polishing using the Epitex strips. Labial surface polishing using the high-shine polisher spiral wheel (EVE Diacomp Plus) and then the DiaPolisher Paste.
