International Journal of Applied Dental Sciences 2021; 7(2): 161-163

ISSN Print: 2394-7489

ISSN Online: 2394-7497
IJADS 2021; 7(2): 161-163 A biomimetic approach for class 1 restorations using
© 2021 IJADS
www.oraljournal.com
stamp technique: A case report
Received: 11-01-2021
Accepted: 22-02-2021
Rahul Gupta, Sophia Thakur, Mallikarjun Goud K, Fares KT and Arun
Rahul Gupta Jayasheel
Post Graduate Student,
Department of Conservative
DOI: https://doi.org/10.22271/oral.2021.v7.i2c.1203
dentistry and Endodontics,
Bapuji Dental College and
Hospital, Davangere, Abstract
Karnataka, India Minimal invasive dentistry advocates the principle of minimal loss of tooth structure along with its
harmonious relationship with the surrounding hard and soft tissues. Proper occlusion in the form of its
Sophia Thakur cusp-fossa relationship is essential to achieve post any restoration. This minimizes any sort of post-
Professor, Department of procedural discomfort to the patient. Stamp technique is a viable, simple and accurate procedure for the
Conservative dentistry and restoration of class 1 carious lesion in an aesthethic and biomimetic manner.
Endodontics, Bapuji Dental
College and Hospital, Davangere, Keywords: Minimal invasive dentistry, stamp, cusp-fossa relationship
Karnataka, India

Mallikarjun Goud K Introduction

Professor and Head of the With the advent of modern clinical dentistry and its increased demand for aesthethic
Department, Department of restoration, there has been a paradigm shift from the traditional silver – amalgam restoration to
Conservative dentistry and a more biomimetic tooth coloured restoration.
Endodontics, Bapuji Dental
College and Hospital, Davangere,
Depending upon the loss of tooth structure, either a direct or an indirect restoration is
Karnataka, India advocated. The restoration theraphy poses several challenges such as obtaining proper contact
and contour, achieving proper isolation, time consumption and its technique sensitivity
Fares KT involved [1]. However, not much consideration is given on achieving of a precise and detailed
Post Graduate Student, occlusion form. Discripancies in the occlusion following a restoration, can prove detrimental
Department of Conservative
dentistry and Endodontics,
to the treatment procedure and cause varied problems such as post-operative pain, difficulty in
Bapuji Dental College and mastication and eventual fracture of the restoration leading to its failure [2].
Hospital, Davangere, In order to achieve proper occlusal harmony and its precise detail to anatomy, a rather simple
Karnataka, India and novel method of “Stamp technique” has been introduced to restore small – to-moderate
Class 1 carious lesions in the posterior quadrant region. It involves the preparation of an index
Arun Jayasheel
prior to caries excavation, wherein this index is then submerged onto the last increment of the
Reader, Department of
Conservative dentistry and uncured composite restoration [3]. It prime goal is the recreation of an exact replica of the
Endodontics, Bapuji Dental occlusal anatomy of a tooth [4].
College and Hospital, Davangere, This case-report highlights the use of stamp technique in restoration of Class 1caries and its
Karnataka, India special consideration to Biomimetics.

Case Report-1
A 22 year old male patient reported to the Department of Conservative Dentistry and
Endodontics with a chief complaint of decayed tooth in the lower right back tooth region. No
pain was associated. Patient did not give any significant medical or previous dental history. On
clinical examination, a Class 1 carious lesion was seen on the occlusal aspect of mandibular
Corresponding Author: right third molar, which was mainly restricted on the pit and fissure region. Cuspal inclines
Rahul Gupta were normal and no parafunctional habits were noted. Radiographically, an occlusal
Post Graduate Student, radiolucency was seen involving the enamel and a part of dentin. Following this, the patient
Department of Conservative was explained about the condition and the treatment protocol and a written consent was
dentistry and Endodontics,
obtained. Oral prophylaxis was done followed by rubber dam isolation. A single coat of
Bapuji Dental College and
Hospital, Davangere, vaseline was applied onto the occlusal surface with an applicator tip. Following this, flowable
Karnataka, India composite was applied onto the occlusal surface, so as to record the occlusal detail.
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The applicator tip was then inserted onto the uncured

flowable composite and and then, light curing was done for
30 seconds. The applicator tip, along with the fabricated
occlusal index was then removed and kept aside. Caries was
then excavated and the cavity surface and walls were cleaned
and dried. Acid etching was done with 37% phosphoric acid
for 15 seconds followed by washing by water for 10 seconds.
The cavity was moist dried followed by bonding agent
application in scrubbing motion for 15 seconds and air dried
followed by light curing for 30 seconds. The cavity was then
restored in an incremental technique by composite restoration
leaving the occlusal 2mm of the cavity unrestored. Composite Fig 1: Pre-operative photograph
was then filled over the remaining cavity, however it was mot
cured. A strip of teflon tape was used to cover the occlusal
surface and the fabricated stamp index was correctly placed
and pressed towards the composite overlying the cavity. The
teflon tape was then removed and the excess material was
removed followed by light curing for 30 seconds. Slight
finishing and polishing was done with Astropol finishing and
polishing kit. The tooth was verified radiographically and the
occlusion was checked for no high points.

Discussion
With the advent of minimal intervention dentistry and a
greater leaning towards the esthetic outlook, there has been Fig 2: Rubber Dam isolation
several modifications in terms of techniques used and the
material aspect for the restoration of posterior Class 1carious
lesions. Several factors come into play for the success of an
ideal composite restoration, which primarily revolves on
minimal polymerization shrinkage and proper cusp-fossa
relationship with the opposing arch [5]. An ideal occlusal
contour is desirable so as to produce an ideal replica of
fissure-margin relation as compared to a healthy tooth [6].
The use of stamp technique in Class 1 carious lesions involves
the replication of the occlusal anatomy, so as to mimic the
natural tooth [7]. Its application is construed to tooth with
intact cuspal planes and along the horizontal progression of
caries involving enamel and dentin.8 Its merit involve less
procedural time, less material consumption and ease of Fig 3: Fabrication of stamp index
technique. Others advantages would be reduced chairside time
as it bypasses the finishing and polishing procedure and its
non-reliance on sophisticated instruments [9].
In this case report, flowable resin composite material was
used so as to record the occlusal details of the carious tooth.
Other materials which can be used for this purpose are pit and
fissure sealants, pattern resin, polyvinylsiloxane impression
material and bite registration paste [10]. Its prime aim should
be it’s ability to record the minute details of the cavity and
mimicking near-to-same occlusal outline [11].
Prior to the stamp preparation, no separating media or
lubricating agent was used onto the occlusal surface of the
tooth as it was a shallow carious lesion. In cases of moderate
to deep carious lesion, separating media like vaseline should Fig 4: Stamp index
be applied, so as to cause easy removal of the stamp index
and prevent any undue damage to the occlusal outline [12].
Following shade selection, composite restoration was placed
in an incremental manner, so as to minimize C-factor and
avoid polymerization shrinkage [13]. Prior to the placement of
the final composite layer, a strip of teflon tape was placed
over the cavity, over which the stamp index was pressed onto.
This is done so as to prevent the sticking of the restoration to
the index [14]. Proper and precise placement of the stamp is a
pre- requisite for achieving proper cusp-fossa relationship.15
Use of this technique and its mastering would prove
beneficial to both the patient and dentist and would comply
with the concepts of Minimal Intervention Dentistry. Fig 5: Caries removal

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Conclusion
Stamp technique is a convenient and favourable technique in
the restoration of Class 1 cavity lesions. Its main focus on
time-saving and accurate replication would prove it to be far
more advantageous than the conventional restoration
procedure.

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Fig 10: Post-finishing and polishing.

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