Extreme Peg Lateral Direct Restoration

8 Jan 2018

16 year old young male patient presented himself with peg lateral incisors. Tooth no: 22 was a severe case, the patient wasn’t happy with his smile. Since the patient and his family came to town just for the treatment, the task needed to be completed in one session. Considering the patient’s age direct composite restoration with no prep approach was preferred as a treatment method. A night guard was recommended for the patient.

Fig. 1

Initial front view of the young patient while smiling.

Fig. 2

Initial side view of the smile. Tooth no. 22 is presented as a peg lateral.

Fig. 3

Wax-up of the plaster model.

Fig. 4

Silicone index prepared from the wax-up model.

Fig. 5

Split rubber dam is placed and teeth are cleaned with pumice.

Fig. 6

Etching procedure is done for 1 minute on the non-prepared teeth and adhesive is applied.

Fig. 7

Palatal surface of the peg lateral was created with injected composite by using silicone index. Contoured transparent matrix band is placed.

Fig. 8

Proximal walls are being created with body composite by using contoured matrix bands.

Fig. 9

Body composite placed vestibularly and mamelons are created.

Fig. 10

Enamel composite is in place and roughly finished.

Fig. 11

Mesial wall of the canine was created roughly with body composite.

Fig. 12

Anatomical lateral form is achieved, finished and polished. The remaining diastemas, large embrasures were restored with body composite for the desired look.

Fig. 13

The new smile of the happy young patient right after the operation. Whole restorations were done in one session.



Peg lateral incisor is a common condition we come across. Orthodontic treatment is not a sufficient treatment method for this condition. There are many treatment methods to restore such cases. Some of these techniques may harm healthy tissues. In minimal invasive dentistry we prefer direct restoration which usually allows us to treat these cases in a single session without any preparation.



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F. Mangani – A. Putignano – A. Cerutti, Guidelines for Adhesive Dentistry.
U. Krueger – Janson, 3D Composites