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).

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Fig.1
Initial situation. Immediately after orthodontic treatment.

style italiano Post-orthodontic direct incisal lengthening

Fig.2
Patient smile before restoration.

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Fig.3
Photo of abrasion of the cutting edges of anterior teeth.

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Fig.4
After anaesthesia, the zeniths of teeth 11 and 12 were corrected.

style italiano Post-orthodontic direct incisal lengthening

Fig.5
Isolation with the rubber dam.

style italiano Post-orthodontic direct incisal lengthening

Fig.6
Rubber dam inversion and retraction with floss. Teeth were sandblasted with 27-micron aluminum oxide.

style italiano Post-orthodontic direct incisal lengthening

Fig.7
Fitting of the silicone key.

style italiano Post-orthodontic direct incisal lengthening

Fig.8
Etching the enamel before the adhesive procedures.

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Fig.9
Restoration of the palatal wall of the incisal edge.

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Fig.10
Restoration of the buccal wall.

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Fig.11
A retainer was placed at the end of the treatment to keep teeth in place.

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Fig.12
Aspect after the restoration.

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Fig.13
After two weeks gums had healed and restorations were integrated.

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Fig.14
View of the incisal edges.

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Fig.15
After restoration.

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Fig.17
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.

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