Direct Composite Incisor Shape Correction

Young male patient presented in the office. The chief complaint was the appearance of the smile, angulation and color of the teeth. After discussing more treatment options, the chosen treatment was conservative direct reconstruction of the upper front teeth with composite resin. The main advantage of direct resin restorations was in this case the low economical and biological cost.

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Fig.1
Initial smile of the patient. He did not like the angulation of the right lateral and canine, the rotated left lateral incisor, ant the overall color of the teeth.

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Fig.2
Initial smile, lateral views.

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Fig.3
Initial smile, lateral views.

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Fig.4
Lateral close-up views.

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Fig.5
Lateral close-up views.

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Fig.6
Close-up view of the upper teeth. Note the tooth axes, and the enamel defect on upper right central incisor.

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Fig.7
After preparation, isolation with rubber dam and conditioning of
the tooth surfaces with 27 micron Al2O3 (Kavo Rondoflex). The preparation was beveling teeth 12 and 21, while more tissue removal was done on tooth 22 to correct the rotation and on tooth 11 because of the enamel defects. The
substrate for bonding is 100% enamel, so bonding is very predictable. A 4th generation bonding agent (Optibond FL) was used.

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Fig.8
Try-in of the silicone index. Note the planned incisal lengthening.

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Fig.9
The restorations vere done 2 at a time, while the adjacent teeth were isolated with teflon tape.

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Fig.10
The mamelons were simulated using dentin materials with different chroma to create natural appearance.

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Fig.11
The final enamel layer was shaped using flat brushes (GC) and silicone brushes (Micerium).

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Fig.12
Fine tuning the shape with abrasive discs.

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Fig.13

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Fig.14
Final smile of the patient one month after completion of the
restorations.

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Fig.15
Final close-up views, lateral. Note the anatomy, surface texture and incisal effects.

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Fig.16

Conclusions

Direct composite restorations are a satisfying option for non invasive esthetic corrections.

Bibliography

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