Stamp Technique
The "stamp" technique is a technique used in operative dentistry, specifically in the restoration of posterior teeth with composite resin material. It involves making a stamp of the occlusal surface before the tooth is prepared for the restoration, which is then used to recreate the occlusal anatomy. Here are the steps:
Tooth Cleaning: Remove any debris, tartar, or plaque from the tooth using an ultrasonic scaler and/or manual hand scalers. The tooth should be clean before starting the procedure.
Preparation of Occlusal Stamp: Prior to any tooth preparation, make an occlusal stamp of the tooth using a suitable material such as polyvinyl siloxane impression material. This will capture the unique occlusal anatomy of the tooth. Let it set per the manufacturer's instructions.
Caries Detection and Removal: Identify the decayed portion of the tooth using an explorer or caries detection dye. Then, remove the decayed part of the tooth using a high-speed handpiece and a suitable bur.
Tooth Preparation: Prepare the tooth for the restoration by creating the appropriate box form or cavity preparation with a suitable bur. Ensure to include all undercuts, rounded line angles, and flat floors to provide an optimal form for the composite resin.
Etching and Bonding: Apply etching gel to the prepared tooth surface for about 15-20 seconds (or according to the manufacturer's instructions) and then rinse it off. Then, apply a bonding agent and lightly air-dry to evaporate the solvent. Cure the bonding agent using a curing light.
Layering of the Composite: Begin the placement of the composite resin in the prepared tooth cavity. The composite should be placed in increments if the cavity depth is more than 2mm. Each increment should be light-cured for appropriate time as per the manufacturer's instructions.
Application of the Stamp: Once the last layer of composite is placed (before curing), press the pre-prepared stamp into the uncured composite resin. This will shape the composite to replicate the original occlusal anatomy of the tooth. Remove the stamp carefully without disturbing the composite, then light-cure.
Finishing and Polishing: After curing, check for any excess and remove it. Use finishing burs and polishing disks or cups to smooth and polish the restoration. Always check for occlusion and adjust if necessary.
Post-operative Instructions: Provide the patient with post-operative instructions regarding oral hygiene, eating, and possible sensitivity.
The "stamp" technique is most suitable for large posterior restorations where occlusal anatomy reproduction could be challenging.
Demonstrated and Explained by Dr. Dilawar Sultan at Akhtar Saeed Medical and Dental College, Lahore.