Fig.1
Initial pre-operative situation (smile view).

Fig.2
Retracted view of the initial situation.

Fig.3
Initial pre-operative situation with contrasted view (black matte background Flexipalettes, Smile Line). Discolored central with old restoration and color mismatch were clearly seen in this picture.

Fig.4
Shade evaluation with polar eyes filter. Small amounts of composite are applied and light-cured (without bonding agent) in an attempt to select the right shade of composite.
This picture could be taken either by the Smile Lite MDP (Smile Line, Switzerland) or by a digital single lens reflex (DSLR).

Fig.5
Rubber dam in action.

Fig.6
Inversion for rubber dam isolation was done by blowing the air around the cervical area and, at the same time, delicately pushing the rubber sheet into the sulcus with a spatula.

Fig.7
Absolute isolation.

Fig.8
Protection of the adjacent tooth to avoid any accidental damage during preparation.

Fig.9
Mark with a pencil the limit of the bevel.

Fig.10
1.5-2 mm bevel was created using a yellow-band flame diamond bur.

Fig.11
Teeth were now ready for adhesion procedure.

Fig.12
Enamel etching was done with 35% phosphoric acid on both teeth #12 and #11.

Fig.13
The surfaces were bonded with a brushing motion using a universal adhesive (Scotchbond Universal, 3M), and light-cured for 1 minute.

Fig.14
Silicon key application for creating the palatal enamel shell; LM Fissura Instrument (LM, powered by Styleitaliano) is used to create a landmark of the area to be restored.

Fig.15
Palatal enamel shell applied with enamel shade.

Fig.16
Proximal walls reconstruction with the help of Unica matrix by Polydentia (Enamel shade).

Fig.17
Solo anterior in action. The new all-in-one, multipurpose instrument known as the LM Solo Anterior Instrument (LM, powered by Styleitaliano) was specifically designed for composite veneers and anterior composite restorations. In this case, it was used for modeling the composite in an easy way.

Fig.18
The palatal shell with the proximal walls were created using enamel shade.

Fig.19
Dentin build-up (dentin shade from 3M), from cervical to incisal was done with one shade.

Fig.20
Application of opalescent effect shade at incisal third (clear enamel shade from 3M).

Fig.21
The compo-brush (Smile Line, Switzerland) was used for modeling the last layer of composite.

Fig.22
Second appointement for checking the shade.

Fig.23
Shape contouring and pre-polishing with a coarse disc Soflex from 3M.

Fig.24
Final post-operative situation after full rehydration.

Fig.25
Final post-operative situation after full rehydration (smile view).

Fig.26
Final post-operative situation after full rehydration.

Fig.27
Final shade evaluation with polar eyes filter. Good color match with lateral incisor after 6 months.

Fig.28
Before and after.

Conclusions

Thanks to these new materials (polar eyes filter to check the shade and Unica anterior matrix for the shape) and reliable techniques, restoring a single central with a direct restoration has become possible, fast, and predictable.

Bibliography

1. https://www.styleitaliano.org/four-levels-of-inversion-for-rubber-dam-isolation/
2. Manauta J, Salat A. Layers: an atlas of composite resin stratification. Quintessence 2022
3. Fahl JR, N. Mastering Composite Artistry to Create Anterior Masterpieces – Part 2. Journal of Cosmetic Dentistry, 2011; Winter 42-55.
4. Báez Rosales, De Nordenflycht Carvacho, Schlieper Cacciutolo, Báez Rosales. Conservative Approach for the Esthetic Management of Multiple Interdental Spaces: A Systematic Approach. J Esthet Restor Dent. 2015 Nov-Dec;27(6):344-54.
5. https://www.styleitaliano.org/single-shade-approach/
6. Hardan L, Bourgi R, Kharouf N, Mancino D, Zarow M, Jakubowicz N, Haikel Y, Cuevas-Suárez CE. Bond strength of universal adhesives to dentin: A systematic review and meta-analysis. Polymers. 2021;13(5):814.