One of my goals with composite restorations is to do as much of the forming and shaping prior to picking up a curing light as I can.

The material is easy to sculpt before it is cured, and access to the surface of the tooth is easier with hand instruments. Once I have placed all the composite and have a dense fill, I remove as much of the excess sitting above the final occlusal surface as I can. With this step accomplished, I turn my attention to creating the occlusal anatomy.

My OptraSculpt handle and disposable tips from Ivoclar Vivadent are perfect for this. The various tip shapes allow me to create incline planes, occlusal grooves and the curve of the marginal ridges into the occlusal embrasures. This process often removes and shapes the composite. My assistant holds a two by two that has been moistened with rubbing alcohol to remove the excess off the end of the instrument. I can place a different shape on each end of the instrument, or I can interchange them as I need them.

Using a series of disposable tips enables me to work without the composite sticking. This has reduced the necessity for meticulous management of expensive instruments which frequently need replacement. And, I resist the desire to use dentin adhesive or an unfilled resin on the instrument to reduce sticking.