Interproximal resto tools: make your diastema predictable

Shadeguides - Tips and tricks - Bleaching - Direct anteriors
15 May 2017

Closing diastemas with a direct technique might seem quite unpredictable; composite resins allow a very conservative treatment that provides us with very natural results, and without removing natural sound tissues. Actual composite resins allow us to mimic natural teeth even when they have been previously bleached. In this clinical case we are going to show some tips and tricks to use anterior matrix and how to get the best out of this kind of treatment.

Fig. 1

Img. 1 – Initial situation of the patient. 50 old year woman comes asking for an esthetic and conservative result

Fig. 2

Img. 2 – In the first appointment we shoot videos, extraoral, intraoral photos and take impressions for the study cast

Fig. 3

Img. 3 – Photographs allow us to obtain a lot of information that normally we don't see during a quick examination of the patient

Fig. 4

Img. 4 – We like to take photographs from different angles to obtain as much information as possible.

Fig. 5

Img. 5 – All of this information is a great tool to communicate with the patient

Fig. 6

Img. 6 – After a DSD analysis we proceed to make the mock-up

Fig. 7

Img. 7 – We show the mock-up to the patient, as it is the best way to communicaticating the final result in a realistic manner

Fig. 8

Img. 8 – Here are some tips to make your mock-up a piece of cake!

Fig. 9

Img. 9 – After having seen the mock-up, the patient accepts the treatment plan

Fig. 10

Img. 10 – We start with our bleaching protocol (White Dental Beauty)

Fig. 11

Img. 11 – After the result is appropriate for the patient we go through the restorative phase

Fig. 12

Img. 12 – TIP: We wait at least 2 o 3 weeks after the whitening to start the adhesive procedures

Fig. 13

Img. 13 – We think isolation is the only way to manage these cases

Fig. 14

Img. 14 – Having the field isolated allows us a better vision and have no influence of the saliva

Fig. 15

Img. 15 – We simply eliminate the aprismatic enamel with a soflex disc

Fig. 16

Img. 16 – We then clean the surface with glycine powder

Fig. 17

Img. 17 – Until everything is really clean

Fig. 18

Img. 18 – Now we proceed with the etching phase

Fig. 19

Img. 19 – Going far away in the enamel

Fig. 20

Img. 20 – And wash it thoroughly

Fig. 21

Img. 21 – We need to be sure that everything is clean and then dry (MDP PHOTO)

Fig. 22

Img. 22 – In this case we use a universal adhesive (MDP PHOTO)

Fig. 23

Img. 23 – We polymerize the adhesive 10 sec from different directions

Fig. 24

Img. 24 – And we start with the palatal enamel

Fig. 25

Img. 25 – With the help of the applica instrument (LM Arte)

Fig. 26

Img. 26 – After removing the index

Fig. 27

Img. 27 – We use a posterir matrix (Polydentia) to imitate the emergence profile

Fig. 28

Img. 28 – My Custom Rings Kit by Style Italiano (Polydentia) contains everything you might want to use for interproximal modelling.

Fig. 29

Img. 29 – TIP: Liquid dam is a great tool to mantain the matrix in place.

Fig. 30

Img. 30 – After removing the matrix, the proximal wall is made.

 

Conclusions

Composite resins used with a direct technique is the most conservative option to solve esthetic problems in a very good way. Additionally, a whole set of tools have been brought to the market to make it even easier. This article has shown how these cases can become predictable and easily manageable.

Bibliography

Devoto W, Saracinelli M., Manauta J. Composite in everyday practice: how to choose the right material and simplify application techniques in the anterior teeth. Eur. J. Esthet Dent 2010; 5: 102-Vanini L. Mangani F. Klimovskaia O. Conservative Restoration of Anterior Teeth. Acme, 2005
Baratieri LN., Araujo Jr E.M. Monteiro Jr S. Composite Restorations in Anterior Teeth: Fundamentals and Possibilities. Quintessence Books
Dietschi D. Layering concepts in anterior composite Restorations. J. Adhes Dent 2001; 3: 71-80

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