A New Technique for New Patients
Minimally invasive black triangle closure using the Bioclear Method and composite injection moulding.
Patients are increasingly interested in restorative treatments that improve their smiles without sacrificing healthy tooth structure.
In this clinical article, Dr Arthur R. Volker demonstrates how the Bioclear Method can provide an additive alternative to conventional crowns and veneers when treating black triangles.
Through a case involving lower anterior black triangles following orthodontic treatment, Dr Volker explores the importance of anatomical matrices, surface preparation and heated composite injection moulding.
Lower anterior black triangles following orthodontic treatment. Clinical case by Dr Arthur Volker.
Patients Want More Than a Beautiful Smile
The article begins with an important observation: patients often want effective aesthetic treatment, but they are understandably reluctant to remove healthy tooth structure.
Preserve Natural Teeth
Many patients prefer restorative approaches that preserve healthy enamel and avoid unnecessary preparation of otherwise sound teeth.
Improve Aesthetics
Patients want natural-looking results that address their concerns while maintaining harmonious tooth proportions and contours.
Explore Treatment Options
Access to information means patients may actively search for alternatives when the initial treatment suggested does not meet their expectations.
An important clinical opportunity:
Dr Volker's case demonstrates why clinicians
should be familiar with contemporary
additive composite techniques when discussing
aesthetic restorative options with patients.
Understanding Black Triangles After Orthodontics
Open gingival embrasures can become particularly noticeable after orthodontic alignment has corrected previously crowded teeth.
Why Do These Spaces Appear?
Black triangles develop when the interdental papilla does not completely occupy the space below the contact area between neighbouring teeth.
Several factors can influence their appearance, including crown shape, contact position, gingival recession, periodontal attachment loss and changes in tooth alignment.
When crowded teeth are aligned, triangular crown forms and changes in contact relationships may make previously concealed spaces visible.
This can be frustrating for patients who have successfully completed orthodontic treatment but remain unhappy with the appearance of their smile.
Why Is Treatment Challenging?
Black triangle closure is not simply a matter of adding composite into a gap.
The clinician must consider the position of the contact area, the contour of the restoration as it emerges from the gingival margin, and how the restored teeth will be cleaned and maintained.
Excessively bulky contours or poorly adapted restorative margins may create aesthetic and hygiene problems.
Anatomical matrix selection and careful finishing are therefore important parts of the treatment.
Case Study: Lower Anterior Black Triangle Closure
Dr Volker describes the treatment of a 35-year-old patient who sought a conservative solution after orthodontic treatment.
A Patient Looking for an Alternative
The patient presented with black triangles between his lower anterior teeth following orthodontic treatment.
He had previously discussed treatment with his regular dentist and had been offered crowns or veneers.
Importantly, the affected teeth did not have dental caries, and the patient was reluctant to remove healthy tooth structure to address what was primarily an aesthetic concern.
After researching alternative options, he found Dr Volker's practice.
Following consultation and clinical photography, a minimally invasive Bioclear composite approach was planned and agreed.
Before & After: A Conservative Transformation
The clinical images illustrate the changes achieved through additive composite restoration, without the tooth preparation that would ordinarily be required for crowns or veneers.
The Clinical Outcome
Dr Volker reports completing the procedure, from rubber dam isolation through to final polishing, in less than two hours.
The published case demonstrates the potential of contemporary composite techniques to reshape anterior teeth and reduce open gingival embrasures without removing healthy tooth structure.
A key objective was to achieve appropriate gingival emergence profiles while providing smooth, accessible restorative surfaces.
Clinical perspective:
These photographs document an individual case
and its immediate treatment outcome.
They do not establish long-term restoration
survival or guarantee equivalent results
for other patients.
Clinical photographs reproduced from the existing Bioclear UK article. Original case: Dr Arthur R. Volker, Dentaltown 2019.
The Clinical Technique: Step by Step
The original publication details a systematic approach to black triangle closure using the Bioclear Method.
Isolation
Rubber dam isolation was established to protect the soft tissues, control moisture and improve access to the interproximal surfaces.
Biofilm Removal
A Bioclear Blaster slurry polisher was used to clean the bonding surfaces and remove biofilm before the adhesive procedures.
Matrix Selection
The Bioclear Black Triangle Gauge helped guide selection of the appropriate anatomical matrices for the required restorative contours.
Adhesive Protocol
Adhesive was applied to the tooth surfaces in preparation for composite injection moulding, following the technique described in the original article.
Composite Injection
Warmed flowable and universal composites were used with the anatomical matrices to create the new interproximal contours.
Finishing & Polishing
Excess composite was removed, the restorations were polished, and the proximal contours were checked for overhangs.
Materials used in the 2019 case:
Dr Volker reports using Scotchbond Universal,
Filtek Bulk Fill Flowable and Filtek Universal
from 3M Oral Care, together with
Bioclear anatomical matrices and
finishing and polishing instruments.
These reflect the original case;
clinicians should follow current
material-specific instructions and protocols.
Why Anatomical Matrices Make the Difference
One of the most important technical points in Dr Volker's article is the role of anatomically designed matrices in creating suitable restorative contours.
Moving Beyond Flat Mylar Strips
Traditionally, clinicians have often relied on flat Mylar strips when placing anterior composite restorations.
While useful in some clinical situations, flat strips provide limited assistance when attempting to develop the gingival emergence contours needed for black triangle closure.
Bioclear Black Triangle matrices have anatomical curvature designed to help control the contour of the composite restoration.
Their profile assists with establishing a contact area positioned more gingivally, allowing the clinician to reduce the visible open embrasure.
Appropriate matrix seating also helps develop smoother contours towards the gingival margin.
Three Important Matrix Functions
1. Gingival Adaptation
The matrix is shaped to help
achieve an appropriate seal and
restorative contour towards
the gingival margin.
2. Contact Position
Anatomical curvature helps
create a longer contact area,
extending towards the gingiva
where clinically appropriate.
3. Emergence Profile
The matrix helps guide the
transition from the root
and cervical tooth surface
towards the incisal portion
of the restoration.
The objective is not simply to fill the gap.
Black triangle closure requires an appropriate
balance between aesthetic improvement,
restorative contours and periodontal
compatibility. Composite reshapes the
space between teeth; it does not,
by itself, guarantee regeneration
of the interdental papilla.
Why Patients May Choose This Approach
The clinical case highlights several reasons why minimally invasive composite dentistry can be an attractive treatment option.
Tooth Preservation
Additive composite techniques can offer treatment options that preserve healthy enamel rather than routinely requiring conventional crown or veneer preparation.
Aesthetic Improvement
Restorative reshaping can reduce the appearance of black triangles and improve tooth proportions when the case is suitable.
Direct Treatment
In selected cases, direct composite treatment can be completed without laboratory fabrication. The published case was completed in a single appointment.
Case selection remains important.
Bioclear black triangle closure is not suitable
for every patient. Tooth shape, periodontal
health, occlusion, existing restorations
and aesthetic expectations must all
be considered before treatment.
The Five Pillars of the Bioclear Method
The technique illustrated in Dr Volker's article can be understood within the wider Bioclear restorative methodology, built around five complementary principles.
Biofilm Removal
Thorough cleaning of the tooth surfaces before adhesive procedures.
Preparation Design
Appropriate, conservative preparation principles designed around the clinical situation.
Anatomical Matrices
Purpose-designed matrices that help establish the intended restorative contours.
Heated Injection Moulding
Controlled placement of appropriately heated composite using the matrix system.
Rockstar Polishing
Systematic finishing and polishing to create smooth restorative surfaces.
Read the Full Article by Dr Arthur Volker
A New Technique for New Patients
Dr Arthur R. Volker, DDS, MSEd
Dentaltown, November 2019
Pages 33–35
Read the original clinical case, including the treatment sequence, materials used and published photographs.
Frequently Asked Questions
Common questions about black triangle closure and conservative composite restorative techniques.
Why do black triangles sometimes appear after orthodontic treatment?
When crowded teeth are aligned, differences in tooth shape, contact position and the height of the interdental papilla may become more apparent. This can reveal open gingival embrasures that were previously less noticeable.
Can Bioclear close black triangles without drilling healthy teeth?
In suitable cases, Bioclear black triangle treatment can be largely or entirely additive. However, the amount of preparation required depends on existing restorations, tooth condition and the individual clinical circumstances.
Why use anatomical matrices instead of flat Mylar strips?
Anatomical matrices help control the gingival and interproximal contours of the restoration. Their curvature can assist with positioning the contact area more gingivally and developing an appropriate emergence profile.
Does closing a black triangle regenerate the gum papilla?
Composite black triangle closure primarily works by reshaping the teeth and changing the space between them. Changes in gingival tissue position may occur in some circumstances, but papilla regeneration cannot be assumed or guaranteed.
How long does Bioclear black triangle treatment take?
Treatment time varies depending on the number of teeth involved, anatomy and the complexity of the case. Dr Volker reported completing the published six-tooth case in less than two hours. This should not be regarded as a standard appointment duration.
How long do Bioclear black triangle restorations last?
Restoration longevity depends on factors including the clinical situation, occlusion, oral hygiene, material selection and maintenance. The published case demonstrates an immediate result rather than long-term clinical performance.
Where can dentists learn Bioclear black triangle closure?
Bioclear Matrix UK offers hands-on courses covering anatomical matrix selection, black triangle closure, composite injection moulding and the wider Bioclear Method. Visit our Black Triangle course page to explore current training.
Continue Exploring Bioclear Dentistry
Discover more about the techniques and restorative principles used in modern Bioclear treatment.
Learn to Close Black Triangles with Bioclear
Discover how anatomical matrices and composite injection moulding can be used to address open gingival embrasures through conservative restorative treatment.
Our hands-on courses provide practical training in matrix selection, emergence profiles, restorative techniques and finishing protocols.
Explore Black Triangle Training →Unhappy with Black Triangles Between Your Teeth?
If you have black triangles following orthodontic treatment or changes in your gums, Bioclear may offer a conservative restorative option.
A dentist with relevant Bioclear training can assess your teeth and discuss whether the treatment is suitable for your situation.
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