worn upper incisors

Post-orthodontic direct incisal lengthening

A clinical case by our Community member Dr. Roma Turetsky

 

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.

 

This patient underwent a complex orthodontic treatment in our clinic to correct an open bite. After the orthodontic treatment, the patient was referred to me to restore the abrasion of the incisal edges of the anterior teeth, and to change the volume of the teeth.
A silicone impression was previously obtained for a wax-up on which a silicone key was fabricated. The restoration was carried out with composite shaded BL and WE, Estelite Asteria (Tokuyama).

intraoral picture of teeth in occlusion

Fig.1

Initial situation. Immediately after orthodontic treatment.

patient smiling before restoration of upper teeth

Fig.2

Patient smile before restoration.

intraoral picture showing upper worn teeth

Fig.3

Photo of abrasion of the cutting edges of anterior teeth.

electrosurgicallt corrected gingival heights

Fig.4

After anaesthesia, the zeniths of teeth 11 and 12 were corrected.

rubber dam isolation of the upper arch

Fig.5

Isolation with the rubber dam.

floss ligatures for dam retraction

Fig.6

Rubber dam inversion and retraction with floss. Teeth were sandblasted with 27-micron aluminum oxide.

silicone index try-in

Fig.7

Fitting of the silicone key.

etching of the whole anterior sextant

Fig.8

Etching the enamel before the adhesive procedures.

palatal incisal composite build up

Fig.9

Restoration of the palatal wall of the incisal edge.

composite incisal lengthening

Fig.10

Restoration of the buccal wall.

upper fixed retainer after orthodontic treatment

Fig.11

A retainer was placed at the end of the treatment to keep teeth in place.

incisors after composite restoration and gingivectomy

Fig.12

Aspect after the restoration.

shiny and seamless direct tooth restorations

Fig.13

After two weeks gums had healed and restorations were integrated.

upper teeth after composite incisal lengthening

Fig.14

View of the incisal edges.

intraoral view of restored upper teeth

Fig.15

After restoration.

smile of patient after incisal restoration

Fig.16

Smile photo.

Conclusions

Composite materials allow to directly restore teeth without tissue preparation. The preliminary wax-up procedure greatly facilitates the work and provides an outline of the future restoration. The BL composite shade allowed to achieve the highly aesthetic result required.

Bibliography

1. Manauta J, Salat A. Layers. An Atlas of Composite Resin Stratification. Quintessence 2012.
2. 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: 102-124.
3. Baratieri LN, Araujo Jr EM, Monteiro Jr S. Composite Restorations in Anterior Teeth. Quintessence 2005.
4. Dietschi D. Optimizing smile composition and esthetics with resin composites and other conservative esthetic procedures. Eur J Esthet Dent 2008; 3(1):14-29.