THE STAMP TECHNIQUE FOR DIRECT COMPOSITE RESTORATIONS

Intoduction: A high level of aestheticscanonlybeachieved by refiningold techniques and introducing new ones. One of the mostrecent techniques is the "stamptechnique".Thisis a relatively new methodthat manages to restore the occlusal anatomyalmostperfectly. Althoughitispractical, it has been adopted by only a smallpercentage of practitioners. Methods: This technique wasused on two patients with occlusal caries of differentseverity, whichallowed for an estheticfillingwith a close approximation of the natural dental anatomy. Results: An estheticrestorationwithoutretouching andwithoutoverbiteallowing a hormonal integration in the occlusion. Discussion: This isbecausemanualrestoration in esthetic direct composite is a technique thatrequiresskill and finesse and finishingthatis essential for the longevity of the restoration. With the buffer technique the overall time isreduced and the degree of porosity in the restorationisconsiderablyreduced. The purpose of this article is to clarifythis technique, to discussits limitations and indications as to illustrateitsprotocolthrough a clinical case.


Intoduction:
A high level of aestheticscanonlybeachieved by refiningold techniques and introducing new ones. One of the mostrecent techniques is the "stamptechnique".Thisis a relatively new methodthat manages to restore the occlusal anatomyalmostperfectly. Althoughitispractical, it has been adopted by only a smallpercentage of practitioners. Methods:This technique wasused on two patients with occlusal caries of differentseverity, whichallowed for an estheticfillingwith a close approximation of the natural dental anatomy. Results:An estheticrestorationwithoutretouching andwithoutoverbiteallowing a hormonal integration in the occlusion. Discussion:This isbecausemanualrestoration in esthetic direct composite is a technique thatrequiresskill and finesse and finishingthatis essential for the longevity of the restoration. With the buffer technique the overall time isreduced and the degree of porosity in the restorationisconsiderablyreduced. The purpose of this article is to clarifythis technique, to discussits limitations and indications as to illustrateitsprotocolthrough a clinical case.
For the abovereasonswhy not consider the development of a new method of restauration, whichcouldallowan exact rehabilitationidentical to the initial dental structure?
Corresponding Author:-Fatima Zahra Amessegher Address:-Resident in the Conjoint Prosthodontics and Occclusodontics Department, School of Dentistry, Hassan II University of Casablanca-Morocco.

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This is the principle of the « Stamp Technique »whichsucceeds in restoring the occlusal anatomyalmostperfectly; this technique consists of making an impression of the decayed occlusal surface, whichisthenapplied to the final restoration composite beforeitis light-cured to impose the original shape of the tooth.
Infact, the manualrestoration in direct aesthetic composite is a technique thatrequiresskills, finesse and a finishingtouchthatare essential for the longevity of the restoration. With the stamp technique the overall time isreduced and the degree of porosity in the restorationisconsiderablyreduced.
However,theonly scenario in which the stamp technique is possibleiswhen the tooth has intact anatomicalcharacteristics and an occlusal surfacethatis not damageddespite the presence of a cariouslesion.
This implies surprise caries withclinically imperceptible cavitation. The technique itselfconsists of an impression of the occlusal surface in the form of an isomouldbeforeanypreparation, sothatthis impression canbeusedlater on to sculpt the future restoration.
This technique presentsomebenefitssuch asavoiding the risks and consequences of a posteriorrestorationthatdoes not meet the physiologicalcriteria of occlusion.
The purpose of this article is to describe the method andpresent thematerialnecessary for the implementation of arestorationusingthe stamptechniquethrough 2 clinical cases.  (Figure 9). To impress the occlusal anatomy a heavy C-silicone key wasrebasedwithits light silicone to reproduce the relief of the occlusal surface via the good fluidityoffered by thismaterial (Figure 11). After isolation of the tooth and removal of decayed dental tissues, the restorationwith composite layer by layer wasmade (Figure 12). During the last application of the composite and before the final light curing, the silicone impression isrepositioned on the occlusal surface with digital pressure and then gently removed. (Figure13and 14). Picture of the restorationjustafter the light curing and (Figure15) a pictureafterfinishing.(figure16)

Discussion:-
The "stamp technique" canbeused in multiple cases. It isuseful in the case of sulcus caries or hidden caries called surprise and even for proximal cavitieswhere the occlusal anatomyispreserved. (1) Inmatter of fact, the preservation of the initial morphology of the original occlusal anatomyis the major asset of this technique (2). Moreover, thismethodis time saving, once the technique isacquired, since the stampallows to reproduce the occlusion in one gesture. And with the removal of the Teflonsheet or the key, only the excess composite that has blown off isremoved. Alsoamong the advantageswe have minimal requirement of finishing and polishing. This technique alsoavoidsoverbite and thusprevents occlusal trauma. (2) In addition, the pressure exerted by the stampreduces the formation of oxygenbubbleswithin the composite(4).
The stamp techniquedoes not requireanyspecific instruments for itsrealization. A microbrush, aflowable composite and a Teflon tape are the minimum required for itsrealisation. It shouldbenotedthat the flowable composite used for the realization of the stampcanbereplaced by liquid dyke, or acrylic/calcinable resin or even silicones and the Teflontapecanbereplaced by stretchable transparent film.
Also, thistechnique requiressomelearning time. The development of the stamp and its use are twostepsthatcanbedelicate and requirea certain dexterityfrom the operator.
Furthermore, beforeadding the Teflon tape, itisnecessary to know how to manage the quantity of composite to polymerize, withoutdisturbing the insertion of the stamp. The last layer of composite must be as thin as possible (about 1mm) in order to limit the shrinkage stress as much as possible. (6) Conclusion:- The impression of a decayed but morphologically intact occlusal surface prior to a restorationoffers the ability to achieve a treatmentthatperfectlymeets occlusal expectations. The establishment of thismethod and the accuratemorphological reproduction itoffersmakesit one of the conservative dentistrytechniques to joindaily practice of dentistswhen all the conditions for itsoperation are met.