Align then Restore

This patient came to the clinic seeking for an aesthetic improvement. As wear of the central incisors wasn’t the only issue to be addressed, the patient was advised to get an orthodontic alignment prior to restoring the incisors.

style italiano styleitaliano

Fig.1
Before treatment with aligners.

style italiano styleitaliano clear orthodontic aligners

Fig.2
During the treatment with aligners.

style italiano styleitaliano smile after treatment with clear aligners

Fig.3
After the treatment of 24 months with B Invisible aligners.

style italiano styleitaliano rubber dam isolation of anterior teeth

Fig.4
For the restorations, the CompoSite kit (White Dental Beauty) was chosen, Teeth were isolated before proceeding to restoration.

style italiano styleitaliano white dental beauty composite system
style italiano styleitaliano white dental beauty composite system
style italiano styleitaliano old composite removal on lateral incisor

Fig.5
An old composite restoration was first removed from the upper left lateral incisor.

style italiano styleitaliano all enamel surfaces were etched

Fig.6
Frosty white enamel after correct etching.

style italiano styleitaliano bonded dental surfaces

Fig.7
Then a bonding agent was applied.

style italiano styleitaliano unica matrix used to contour the outer shape of the restoration

Fig.8
After filling the lateral incisors, we proceeded to place the Unica matrix regular to build the outer frame of the new shape. For the palatal and proximal build-up the E shade was chosen.

style italiano styleitaliano unica matrix for direct veneering of central incisor

Fig.9
Then, the frame of the adjacent incisor was created with the same procedure.

style italiano styleitaliano layering direct composite veneers

Fig.10
After shaping the outer frame and proximal walls.

style italiano styleitaliano composite direct veneering

Fig.11
The outer build up was finished before layering the dentin mass.

style italiano styleitaliano finished composite direct veneers

Fig.12
After the restorations were finished and all excess material removed, they were polished with the LucidaTM composite polishing system.

style italiano styleitaliano central incisor direct veneers after rubber dam removal

Fig.13
After treatment.

style italiano styleitaliano direct composite veneers after polishing

Fig.14
Final result.

style italiano styleitaliano smile after direct composite veneers restoration of central incisors

Fig.15
A satisfied smiling patient with her newly shaped central incisors.

Conclusions

Although an orthodontic alignment implies a treatment will be longer, it makes a difference in placing the foundation to a stable and satisfying result. The patient will often then need minimally invasive intervention to get the desired aesthetics.

Bibliography

  1. Manauta J, Salat A, Putignano A, Devoto W, Paolone G, Hardan LS. Stratification in anterior teeth using one dentine shade and a predefined thickness of enamel: A new concept in composite layering – Part II. Odontostomatol Trop 2014; 37 (47): 5-13.
  2. Gill S, Naini F, Tredwin C. Smile aesthetics. Dent Update 2007;34:152–8.
  3. Price RB, Dérand T, Sedarous M, Andreou P, Loney RW. Effect of distance on the power density from two light guides. J Esthet Dent. 2000;12:320–7.
  4. Nitta K. Effect of light guide tip diameter of LED-light curing unit on polymerization of light-cured composites. Dent Mater. 2005;21:217–23.
  5. Rueggeberg FA. State-of-the-art: dental photocuring – a review. Dent Mater. 2011;27:39–52.
  6. Morley J, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc 2001; 132: 39–45.2. References….

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