Every day patients ask for esthetic treatment and more and more often they want to improve their esthetic in a short time. But there are situations in which it’s impossible to restore function and esthetics without going through an orthodontic treatment, in order to give the prosthodontic or restorative clinicians the best way obtain the best results. However, at the end of the orthodontic treatment, the prosthetic finalization must be delayed for 6-12 months, waiting for the occlusion adjustment and recovery. During this time, it’s mandatory to stabilize the results providing provisional restorations. In this fields, EGR (Esthetic Guided Restorations) can be widely and conveniently employed. They allow to maintain stable occlusion combined with good esthetic in front teeth. The shell of EGR are completely pre-polymerized with an high conversion degree. This mean more stability during time in abrasion, color, mechanical properties etc.
In 2012 became at our observation P.B., age 53, presenting a Class III malocclusion with negative overjet and multiple abfraction and abrasion.
The orthodontic treatment, lasted 22 months, involved upper incisors proclination, lower incisors stripping and torque control and Class III mechanics using intermaxillary elastics.
The same day of the debonding, the upper incisors were restored. No surface preparation was performed, only a surface sandblasting with aluminum oxide.
After rubber dam isolation, 4 componeer (Large size, Universal value) were relined using composite. In order to simplify the luting stage, the EGR have been applied one by one, and the cervical limit determined by a 9T clamp. Finishing and pre polishing were performed using burs, abrasive discs and strips, and EVA handpiece.
One week later adjustments of shape and size were made, as well as final polishing and surface texture.
Pre and post EGR smile display: notable improvement of esthetic was obtain only in 1 appointment.
One year follow up shows the maintenance and stability of the restoration in shape, color, marginal adaptation and texture
At this time, as the occlusion is stable, the patient may begin the prosthetic treatment with porcelain veneers.