One diastema closure at a time

A clinical case by our Community member Dr Mustafa Ali

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

Diastema closure cases pose significant challenges, particularly in the aesthetic domain where imperfections are highly noticeable. Advances in technology and ongoing scientific research on materials and techniques have simplified daily clinical practice, yielding predictable and effective outcomes. Achieving a natural shape in anterior teeth relies on factors such as outline, light reflection, surface texture, and gloss. In this article, the essential guidelines for achieving a natural diastema closure using the bioclear method will be outlined.

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Fig.1
Initial situation.
Close-up view showing diastema with old overhanging composite in the middle and cervical area. The removal of the overhang composite is necessary to facilitate rubber dam placement.

style italiano styleitaliano mustafa ali Isolation

Fig.2
Isolation.
Rubber dam isolation is a necessary step for ensuring a moisture-free working environment during adhesive procedures. Subsequently, sandblasting with 25 um aluminum oxide was employed.

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Fig.3
Matrix placement.
Using clamp b4 for better retraction is essential. Following that, double bioclear bands DC 202 are placed for diastema closure. These bands effectively separate the space into two equal parts.

style italiano styleitaliano mustafa ali Bonding and curing

Fig.4
Bonding and curing.
After acid etching and bonding the teeth, the emergence profile is crafted using flowable composite. Subsequently, it is light-cured using an Eighteeth CuringPen (Eighteeth, Changzhou, China) capable of reaching deep areas of the composite.

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style italiano styleitaliano mustafa ali Composite placement

Fig.5
Composite placement.
Following the creation of the emergence profile for both teeth and the placement of a wedge to ensure adequate separation, composite adaptation is performed for the first tooth using 3M Body Shade A2 composite. Subsequently, light curing is carried out. Then, one band is removed, and the process is repeated in a similar manner for the second tooth.

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Fig.6
Composite placement.
After getting the proximal profile for both teeth and removing the second band, the final layer was placed in labial surface with enamel shade.

style italiano styleitaliano mustafa ali rubber dam

Fig.7
Final situation under rubber dam.
Immediately after adding the enamel shade, reshaping is initiated using a coarse disc, followed by finishing with enhance finishing burs. Finally, polishing is carried out using a Jota polishing wheel and Lucida polishing paste (Diashine) for the final glaze.

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style italiano styleitaliano mustafa ali diastema

Fig.8
Final situation.
Final result after rubber dam removal. The dentist and the patient were very happy with the final result.

style italiano styleitaliano mustafa ali conclusion

Fig.9
Final situation.
Side view showing three planes of the teeth.

Conclusions

Diastema closure demands meticulous attention to detail and the utilization of advanced techniques. By employing the bioclear method, one can achieve not only aesthetically pleasing results but also predictable and long-lasting restorations.

Bibliography

  1. Vanini L (1996). Light and color in anterior composite restorations. Pract Periodont Aesthet Dent 8:673-682. Duarte S, Perdigão J, Lopes M (2003). Composite resin restorations Natural aesthetics and dynamics of light. Pract Proced Aesthet Dent 15:A-H.
  2. Perdigão J (2010). Dentin/Enamel bonding. J Esthet Restor Dent 22:82-85.
  3. Devoto W, Saracinelli M, Manauta J. (2010). Composite in everyday practice: how to choose the right material and simplify application techniques in the anterior teeth. Eur J Esthet Dent Spring;5(1):102-24.
  4. Perdigão J, Sezinando A, Monteiro PC. (2012). Laboratory bonding ability of a multi-purpose dentin adhesive. Am J Dent Jun;25(3):153-8.
  5. Paolone G, Orsini G, Manauta J, Devoto W, Putignano A. (2014). Composite shade guides and color matching. Int J Esthet Dent Summer;9(2):164-82.
  6. Manauta J, Salat A, Layers, an Atlas of composite resin stratification, Quintessence 2012.
  7. Manauta J, Salat A, Putignano A, Devoto W, Paolone G, Hardan LS. Stratification in anterior teeth using one dentine shade and a predefined thickness of enamel: a new concept in composite layering-Part II. Odontostomatol Trop. 2014 Sep;37(147):5-13.
  8. Betrisey E, Krejci I, Di Bella E, Ardu S. The influence of stratification on color and appearance of resin composites. Odontology. 2015 Feb 5
  9. Gönülol N, Yilmaz F. J. The effects of finishing and polishing techniques on surface roughness and color stability of nanocomposites. Dent. 2012 Dec;40 Suppl 2:e64-70

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