Aesthetics in Composite Resins

A clinical case by our Community member Dr Ramon Figueiredo

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

In this clinical case, composite resin was utilized to achieve both aesthetic and functional enhancements for the patient. The meticulous process began with digital planning facilitated by a skilled technician. Comprehensive data collection, including scanning and photography, laid the foundation for precise execution.

style italiano styleitaliano initial situation before direct anterior composite restoration resin composite veneers

Fig.1
The clinical case presented an initial situation captured through intraoral photo, revealing unsatisfactory composite resin restorations that compromised both aesthetics and oral health, characterized by inadequate dental proportions.

style italiano styleitaliano initial situation before direct anterior composite restoration resin composite veneers

Fig.2
The “Photo Smile” reveals the patient’s primary concern: unfavorable aesthetics and discomfort experienced while using dental floss, prompting a case approach that involved whitening prior to implementing new restorations.

style italiano styleitaliano isolation direct anterior composite restoration resin composite veneers

Fig.3
Absolute isolation was achieved using the tethering technique, facilitated by Nictone rubber dam, dental floss, and W3 Hufriedy staples. The removal of old restorations was meticulously executed through groping with aluminum oxide.

style italiano styleitaliano palatal shell direct anterior composite restoration resin composite veneers

Fig.4
The positioning of the palatal guide was meticulously executed during the planning phase to assess spaces and ensure appropriate adaptation for crafting the palatal shell.

style italiano styleitaliano composite placement direct anterior composite restoration resin composite veneers

Fig.5
The palatal conch was crafted utilizing a silicone guide, followed by the selective etching of enamel using Phosphoric Acid 37% Ultra-Etch (Ultradent Products, Inc., Utah). The Clearfil SE Bond (Kuraray Noritake Dental Inc.,Tokyo, Japan) adhesive system was employed for optimal bonding. High-resistance resin, CT Z350 (3M ESPE, USA), was carefully selected and applied, with precise attention given to delimiting the length, axis, and proportion of the resin restorations.

style italiano styleitaliano composite placement direct anterior composite restoration resin composite veneers

Fig.6
The stratification of the dentin layer, employing serrated jaws and Estelite Omega Color BL2 (Tokuyama, Tokyo, Japan) composite resin, effectively enhances the luminosity of the teeth, elevating their overall value and aesthetic appeal.

style italiano styleitaliano composite placement direct anterior composite restoration resin composite veneers

Fig.7
The application of Estelite Omega WE (Tokuyama, Tokyo, Japan) composite resin, for the enamel layer was followed by the formation of proximal joints using a polyester strip. Subsequent initial finishing meticulously crafted the morphology and primary anatomy to achieve optimal results.

style italiano styleitaliano finishing and polishing direct anterior composite restoration resin composite veneers

Fig.8
Finishing and final polishing were executed meticulously, adhering to the planned primary and secondary anatomical details, ensuring seamless integration with the periodontium (gingival profile) and aesthetic restorations. The process involved utilizing Jiffy Polisher Cup-Ultradent Polishers and EVE Diacomp Plus Espiral-Odontomega Diamond Polisher for superior results.

style italiano styleitaliano final situation direct anterior composite restoration resin composite veneers

Fig.9
Final situation.

Conclusions

The clinical case, executed with stratified composite resins, successfully restored both aesthetics and function, effectively addressing the patient’s primary concern. Through meticulous planning, the procedure offered enhanced predictability for the stratification process and final outcomes. Preceded by whitening, the treatment was conducted under absolute isolation, ensuring a clean, dry operative environment to optimize access and the effectiveness of the adhesive system. This comprehensive approach not only achieved the desired results but also ensured the longevity and satisfaction of the patient’s dental restoration.

Bibliography

  1. Magne P, So WS. Optical integration of incisoproximal restorations using the natural layering concept. Quintessence international. 2008 Sep 1;39(8).
  2. Ferracane JL. Resin composite—state of the art. Dental materials. 2011 Jan 1;27(1):29-38.
  3. Villarroel M, Fahl N, De Sousa AM, de Oliveira OB. Direct esthetic restorations based on translucency and opacity of composite resins. Journal of Esthetic and Restorative Dentistry. 2011 Apr;23(2):73-87.
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