Esthetic Restorations with only one opacity

Esthetic Restorations with only one opacity

When we have a challenge like a central incisor restoration we need the best tools to obtain the best results possible.
Normally when we face a single restoration in anterior sector we immediately think in a polychromatic restoration with several opacities and multi-stratification procedure.
But maybe this is not mandatory always, cause sometimes the characteristics of the teeth allow us to make the procedure simple, thus to this there are new materials that really mimic the effects of the natural teeth with only one opacity.

Esthetic Restorations with only one opacity

Fig.1

Young female patient came to office to change the old restoration in her right central incisor.

direct Restorations with only one opacity

Fig.2

A photograph with a slightly open bite allow us to decide is the restoration needs multiple colors and opacities or we can go with a simple procedure.

direct composite veneer with only one opacity

Fig.3

Close up with black background to check the details of the restoration to be done.

Polarized photo of an Esthetic Restorations with only one opacity

Fig.4

Polarized photo with the MDP device allow us to check the real color of the restoration without reflexions.

teeth after two weeks of bleaching Esthetic Restorations with only one opacity

Fig.5

Prior to do nothing we propose the patient to make a home bleaching procedure with carbamide peroxide at 16% for two weeks. This is the result that we obtain.

3M Filtek Universal on Esthetic Restorations with only one opacity

Fig.6

Filtek Universal is the system we decide to use cause with only one opacity we can match the color of the natural tooth.

MDP color test on Esthetic Restorations with only one opacity

Fig.7

With the help of the MDP we make a color test, we apply three different small balls of universal composite to check which one match better with the natural teeth. As we see in the photo the XW (extra white) color in the one that we are gonna use.

Isolation is mandatory to make an adhesive restoration

Fig.8

Isolation is mandatory to make an adhesive restoration.

eliminate the old restoration for a new Esthetic Restorations with only one opacity

Fig.9

We eliminate the old restoration with high speed and finish with ceramic burs in low speed to eliminate the composite and don’t damage the enamel.

Bevelling the margin on Esthetic Restorations with only one opacity

Fig.10

Bevelling the margin.

aluminium helping the preparation of Esthetic Restorations with only one opacity

Fig.11

29 micronsoxide aluminium help us in the preparation.

teflon tape helping protect adjacent tooth of Esthetic Restorations with only one opacity

Fig.12

With the help of the teflon tape we protect adjacent tooth.

3M universal system adhesive on Esthetic Restorations with only one opacity

Fig.13

We will use a universal system adhesive but we like to use the selective etching approach.

Etching time on Esthetic Restorations with only one opacity

Fig.14

Etching including not only the bevel, going beyond it.

Washing with water is so important to eliminate all rests of etch agent

Fig.15

Washing with water is so important to eliminate all rests of etch agent.

Adhesive time

Fig.16

Adhesive time.

Esthetic Restorations with only one opacity

Fig.17

But first we need to eliminate all the drops…

Adhesive phase is the key for success

Fig.18

Adhesive phase is the key for success.

We polymerize from all the parts of the teeth

Fig.19

We polymerize from all the parts of the teeth.

Fissura instrument marks the limit of the preparation in a silicon key

Fig.20

Fissura instrument marks the limit of the preparation in a silicon key obtain from a digital model created after a intraoral scan impression.

Esthetic Restorations with only one opacity one color

Fig.21

We are gonna use only one color so we just need to fill all the space of the silicon matrix with the XW color prior selected.

model the buccal surface with paintbrush

Fig.22

Paintbrush will help us to model the buccal surface…

Polimerization

Fig.23

Polimerization.

This barrier will help us to obtain a better surface in the final polimerization

Fig.24

This barrier will help us to obtain a better surface in the final polimerization.

Essential Shape on Esthetic Restorations with only one opacity

Fig.25

For the finishing and polishing we start with the primary anatomy following the Essential Shape rules.

polishing With the Sof-lex disc

Fig.26

With the Sof-lex disc.

Details in the embrasures

Fig.27

Details in the embrasures.

Secondary anatomy with a Perio Set bur

Fig.28

Then the secondary anatomy with a Perio Set bur.

polishing time

Fig.29

Now is time for the shine.

polishing direct restoration

Fig.30

With the yellow spiral disc.

polishing direct restoration

Fig.31

And the purple one.

Immediate result before removing rubber dam

Fig.32

Immediate result before removing rubber dam.

Result after removing immediately the rubber dam

Fig.33

Result after removing immediately the rubber dam.

Immediate smile of Esthetic Restorations with only one opacity

Fig.34

Immediate smile.

Two weeks review from lateral side of Esthetic Restorations with only one opacity

Fig.35

Two weeks review from lateral side

smile details of Esthetic Restorations with only one opacity

Fig.36

Smile detail, another restoration was made in the lateral to improve the esthetics.

lateral view of Esthetic Restorations with only one opacity

Fig.37

Lateral view, notice the secondary anatomy.

final result of Esthetic Restorations with only one opacity

Fig.38

Final result.

The patient is satisfied with the result and we obtain a natural restoration in a easy way and simplifying the class IV procedure that normally is one of the most challenge procedures in dentistry.

BIBLIOGRAPHY

1-Hirata R. Shortscuts em Odontologia estetica:uma nova visao sobre TIPS. Capitulo 3: Restauracaos esteticas e transformacoes anteriores. Quintessence Editora Ltda. 1°Edición. 2016; 236-452
2-Manauta J, Salat A. Layers An atlas of composite resin stratification. Quintessence Editora Ltda. 2013 Fahl N Jr. Ultimate aesthetics with composites: When Art and Science Merge. Dentistry Today, p.56-61, Sep. 1999
3-Romero MF. Esthetic anterior composite resin restorations using a single shade: Step-by-step technique. J Prosthet Dent. 2015 Jul;114(1):9-12.