At all times, a smile decided many things. A beautiful smile conquered cities. And if some time ago, it did not get enough attention, in the modern world, this aspect is crucial. Positive emotions and good mood help people not only feel healthier, but also to become more successful in business, in work and in life.
The hormones of happiness for example endorphin, dopamine, and serotonin are allocated in the body while laughing. People with beautiful open smile with straight teeth and that always look really “put-together” have great success.
But not many are naturally so lucky. Because of irregular teeth many people generate complexes, and feelings of inferiority. Due to the inability to openly show their good mood in the society and their hesitating to smile, these people become withdrawn and sullen.
And the same issue we can be noticed in this case report. We were contacted by a patient, 30 years old, complaining of big diastemas and he didn’t feel comfortable with his smile
Before restoration in order to analyze all the defects we should use the intraoral photos. For this case we decided to use a free hand technique guided by Golden Proportions.
Photo from a different angle.
Photo from a different angle. We can notice that we have class 4 cavity on the lateral incisor.
With a Vernier caliper we start to measure from distal side of canine to distal side to another canine.
Golden proportions will tell us what the new size of each tooth should be.
We started by checking the color with classic VITA shade guide. Here we can notice that it is not easy to choose the right color with regular flash.
The best option to choose the right color is to use cross Polarization Filter. For this we can use the camera with filters or a mobile phone with the help of SmileLite MDP (Mobile Dental Photography) device by prof. Louis Hardan which can give us vivid pictures as u see in this slide. In this case A1 color was chosen.
To make sure that we chose the right color we also used the button try technique. We put 1.5 mm thickness of composite and light cured it well. A1/B1 shade from the new submicronic hybrid composite “Brilliant Everglow” was more suitable than A2/B2.
Isolation with rubber dam provides an aseptic and dry environment and improves manual control together with efficiency.
Isolation from premolar to premolar with two N208 clamps. And Nictone heavy dam used for a better retraction.
With a nylon brush and with the abrasive paste we started cleaning all the surfaces of teeth.
For better adhesion and for removing aprismatic enamel we can use sandblaster (Aquacut or Rondoflex) with 27 micron aliminum oxide sand.
In this case we used 35% etching gel, 30 second for enamel.
The etching agent is applied it with a brush.
In this picture we can see the etched edges areas on the enamel. No need to cover all the enamel surface for closing this kind of diastemas. The self etching One Coat Universal Adhesive (Coltene) was applied over the enamel. The adhesive excess was removed using aspiration and air blow. When the adhesive is not moving anymore under the pressure of the air, then we know that the thickness is close to the optimal.
Light curing will be 10 seconds with new S.P.E.C. 3™ LED Curing Light (Coltene).
We started by applying composite. For better adaptation and for the smoothing of the surface of composite we always use brushes. This time it was a CompoBrush (Smile Line, powered by Styleitaliano).
With a Vernier caliper we must control the new size of our tooth.
In free hands technique we always we always forming the contact points with mylar strips.
All teeth were restored in one visit and after layering we started the finishing of our restorations.
After we finalize the restoration we move to contouring part. For removing excesses and contouring of the tooth we can use coarse discs.
We need 3 main phases to obtain a good polishing: contouring, finishing and polishing. Abrasive points used for smoothening all the surfaces. Polishing is finished with silicone abrasive wheels (Diatech Polishers by Coltene).
Before and after restoration all diastemas was closed and we created correct contact points.
The picture with Polarized filter.
Final view of new restorations.
Micro-texture of the restored tooth.
Before and after.
Photo with occlusal mirror.
Before and after.
The New Smile, and new emotions.
Every patient dreams having a perfect smile and our duty as dentists is to do a treatment with minimal harm for the dental structure.
Composites are a good alternative in such situations especially with the positive evolution of these materials.
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