A clinical case by our Community member Dr Giovanna Borelli
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.
Many people are self-conscious when they smile, and dentists now have the ability to plan the smile design based on the patient’s facial profile in order to harmonize and balance the smile in a tailored fashion. Accordingly, the aim of this article is to assess a clinical case of anterior composite restorations following a right plan.
Fig.1
A patient visited the dental office asking for an aesthetic solution for her smile. She complained about unsatisfactory old composite resins, teeth size, and color. Plus, she was looking for a more harmonious smile.
Fig.2
Begin by preparing this case to be predictable (a correct treatment plan was based on the patient’s facial profile). Next, the current composite resins were removed.
Fig.3
Rubber dam isolation was done in an attempt to have a clean field from moisture. Clinicians should practice rubber dam techniques, and never using a rubber dam would not be an acceptable approach.
Fig.4
Through the palatal index, the size and the shape of the planned teeth were transfered to the mouth of the patient.
Fig.5
Dentin placement using a spatula.
Fig.6
Creation of dentin mamelons using fissura instrument (LM, powered by Styleitaliano).
Fig.7
Using a brush, the composite was well adapted.
Fig.8
Composite placement on the adjacent tooth.
Fig.9
A flowable resin composite was placed between the mamelons to emphasize the translucency in the incisal third.
Fig.10
Opalescent composite resin was placed on the mamelons to emphasize more the details.
Fig.11
Freehand layer of enamel following the planning.
The LM Solo Anterior Instrument (LM, powered by Styleitaliano) was used for this layer to adapt the composite to the wall needed. Plus,Tokuyama’s MW composite resin was applied as the final layer for a better polishing of the final situation.
Fig.12
At the finishing stage, the volume and the position of the edges were adjusted according to the initial treatment plan.
Fig.13
Finishing stage.
Fig.14
Pre-polishing stage.
Fig.15
Before following the plan of the new composite resin.
Fig.16
Final result of the upper arch planned according to facial profile. The color choice was chosen based on the face of the patient.
Fig.17
Before and after.
Conclusions
The development of innovative, yet conservative, state-of-the-art resin composite restorative materials and techniques can commonly meet patients’ cosmetic and functional corrective needs today. Furthermore, regardless of the restorative materials used, a proper treatment strategy should be established for improved patient satisfaction in terms of time and cost.
Bibliography
- Freitas, A., & Ottoboni, T. (n.d.). Elementos Constituintes do Sorriso e Planejamento Reverso. Simple.
- Heintze SD, Rousson V, Hickel R. Clinical effectiveness of direct anterior restorations—A meta-analysis. Dental materials. 2015 May 1;31(5):481-95.
