Composites – though being the most commonly used materials in dentistry – have been changing the approach in aesthetic treatment since they have been introduced and clinicians have a range of materials to choose from, based on their treatment needs. Sometimes managing the colour of a restoration on a black metal post could be difficult, mainly if you can not remove it for different reasons.
In this article, through the choice of only one new bulk fill composite, the lecturer points out that masking the post colour and achieving a good aesthetic are possible using only one single mass. A 42 years old female come to our dental practice to improve her smile.
Fig.1
Picture of the patient smile. The patient request was focused on improving the aesthetic of tooth 2.3.
Fig.2
Buccal view of the teeth occlusion.
Fig.3
Particular of the buccal view of the canine. It has a previous reconstruction with staining and some infiltrations.
Fig.4
Adequate isolation is an absolute requirement prior to any adhesive procedure. In this case an isolation was made from premolar 1.4 till the 1st upper.
Fig.5
Buccal view of the canine after isolation. After the initial dehydratation, the previous reconstruction can be easily detected.
Fig.6
In the preclinical rx, a carbon post was evident in the canal. Unfortunately, the economic situation of the patient did not allow to remove it, thus, in agreement with him, we decide to maintain the post and make a direct reconstruction. Removal of the whole previous composite is mandatory to achieve the best aesthetic request. To improve the adhesion, a bevel was made.
Fig.7
Etching step using 3M™ Scotchbond™ Etching Gel.
Fig.8
Bonding step using 3M™ Scotchbond™ Universal Adhesive; the palatal wall was made by using a mylar strip and the 3M™ Filtek Universal Restorative.
Fig.9
The same 3M™ Filtek Universal Restorative used for palatal wall was applied on sectional metallic matrix, by Polydentia, in order to reconstruct the distal wall.
Fig.10
A new clamp was used to expose more dental cervical tissue and put the matrix in order to reconstruct the mesial wall.
Fig.11
The tooth was entirely reconstructed by only one single mass of 3M™ Filtek Universal Restorative. Image prior to finishing and polishing procedures.
Fig.12
Buccal view after removing the rubber dam and after finishing and polishing procedures made by 3M™ Sof-Lex™ disks and 3M™ Sof-Lex™ Diamond Polishing System.
Fig.13
Buccal view after Finishing and Polishing phases.
Fig.14
Buccal views comparing pre and post-operative steps. Although a dentatus (carbone post) was present, the final composite was able to mask the discoloration of the tooth.
Fig.15
The smile of the patient after the restoration.
Conclusions
As this article demonstrates, it is possible achieving a good aesthetic results with only one shade, although we had the color influence of a metal post. In daily restorative dentistry the bulk fill composites are convenient because they are quick and easy to use, thanks to the innovative filler technology which gives to the composite extremely low shrinkage stress values.
Bibliography
[1] R. Monterubbianesi, G. Orsini, G. Tosi, C. Conti, V. Librando, M. Procaccini, A. Putignano, Spectroscopic and Mechanical Properties of a New Generation of Bulk Fill Composites, Front. Physiol. 7 (2016). doi:10.3389/fphys. 2016.00652.
[2] J. Manauta, A. Salat, A. Putignano, W. Devoto, C.F. Villares, L.S. Hardan, Natural, polarized light and the choice of composite: a key to success in shade matching of direct anterior restorations- Part I., Odonto-Stomatol. Trop. Trop. Dent. J. 39 (2016) 11–19.
[3] J. Manauta, A. Salat, Layers, an Atlas of composite resin stratification, Quintessence 2012
[4] A.D. Loguercio, M. Rezende, M.F. Gutierrez Reyes, T.F. Costa, A. Armas-Veja, A. Reis, Randomized 36-month Follow-up of Posterior Bulk-Filled Resin Composite Restorations, J. Dent. (2019).
