No ortho just compo

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Fig.1
A new smile with no invasive procedure? Is it possible to obtain a new smile without drilling or orthodontics?
A patient came to the office asking to change her smile. Of course laminate veneers were not indicated for the case, and the patient refuses orthodontic treatment

style italiano styleitaliano dentistry

Fig.2
The intra-oral view shows canines are missing.

style italiano styleitaliano dentistry

Fig.3
Occlusal view shows the rotation of lateral incisors.

style italiano styleitaliano dentistry

Fig.4
We made an esthetic analysis using stone casts and photos. To do this we used:
– the aesthetic guide described by Andé Faucher and Jean-Christophe Paris
– the digital smile design protocol described by Christian Coachman

style italiano styleitaliano dentistry

Fig.5
After having the Laboratoire Gilles Philip make a wax-up according to the aesthetic diagnosis and the data recorded.

style italiano styleitaliano dentistry

Fig.6
The aesthetic project was transferred into the patient’s mouth to be validated by the patient before starting treatment. After discussing everything with the patient, we chose semi-direct composite veneers on canines, and direct composite restorations on the four incisors.

style italiano styleitaliano dentistry

Fig.7
To fabricate the semi-direct veneers we used a transparent silicone from the wax-up to stamp some enamel composite on teeth 13 and 23.

style italiano styleitaliano dentistry

Fig.8
Composite veneer after light curing through the silicone and before removing excess material.

style italiano styleitaliano dentistry

Fig.9
Then we reduced the thickness from inside the veneer down to 0.5 mm for the buccal shell.

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Fig.10
The 0.5 mm veneer was filled with dentin composite and applied on the canines, and excess material was removed. The picture shows the veneer tried on tooth 13. The same procedure was carried out for tooth 23.

style italiano styleitaliano dentistry

Fig.11
After luting the veneers on the canines with individual rubber dam isolation, the direct composite restorations can be done on the incisors, according to the aesthetic project.

style italiano styleitaliano dentistry

Fig.12
After sandblasting, the enamel was etched with 37% phosphoric acid for 30 seconds.

style italiano styleitaliano dentistry

Fig.13
Then enamel surfaces were bonded.

style italiano styleitaliano dentistry

Fig.14
Direct composite stratification on teeth 12, 11, 21 and 22.

style italiano styleitaliano dentistry

Fig.15
Finishing procedures were carried out after rubber dam removal.

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Fig.16
The shape of the distal walls of 11 and 21 was changed.

style italiano styleitaliano dentistry

Fig.17
One month check-up.

Bibliography

1. Jean-Christophe Paris, André-Jean Faucher. Le Guide esthétique : comment réussir le sourire de vos patients. Quintessence international 2003
2. Jordi Manauta, Anna Salat. Layers : an atlas of composite resin stratification. Quintessence 2012.
3. Christian Coachman, Marcelo Calamita. Digital Smile Design: a tool for treatment planning and communication in esthetic dentistry. QDT 2012

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