Smile make-over with composite

A clinical case by our Community member Dr Mohammed Haji

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.

In the realm of restorative dentistry, the evolution of materials and tools, including adhesive systems, composite resins, spatulas, and brushes, has revolutionized dental practices and elevated patient care. Yet, despite these strides, many practitioners encounter complexity and time constraints when performing composite resin lamination procedures in the anterior region. The pursuit of durable, virtually imperceptible restorations within feasible timeframes persists as a common challenge. This article demonstrates that by embracing the concept of task segmentation in restorative dentistry, the process of crafting composite resin restorations in the anterior area can be streamlined into a series of simple and reproducible steps. Through adherence to a well-defined schedule and precise execution of each stage, predictable and gratifying outcomes are attainable.

style italiano styleitaliano initial situation diastema direct composite restoration

Fig.1
In the initial encounter, a 32-year-old dentist presented at the clinic seeking resolution for his diastema and short teeth, expressing a desire for a brighter and more prominent smile, with visible complications evident upon examination.

style italiano styleitaliano initial situation diastema direct composite restoration

Fig.2
The diastema and canting can be determined and measured accurately.

style italiano styleitaliano initial situation diastema direct composite restoration

Fig.3
Side view of the patient to determine the length: width ratio.

style italiano styleitaliano initial situation diastema direct composite restoration isolation

Fig.4
Capture a detailed aesthetic photo to assess the zenith point, gingival contour, axial inclination, and incisal embrasure. Isolate the teeth using a rubber dam in a split-dam technique to eliminate interference from lips, tongue, and saliva.

Fig.5
After creating mamelons, a color clear tint is applied to ensure optimal adaptation to the composite. Video documentation with MDP (mobile dental photography) is then carried out.

Fig.6
Injectable BW composite is used to create the incisal halo, followed by video documentation with MDP.

style italiano styleitaliano Pull-down technique

Fig.7
A transparent matrix is employed to create a proximal wall using a pull-down technique.

style italiano styleitaliano Shaping stage direct composite restoration diastema closure

Fig.8
During the shaping stage, irregularities and depressions can be corrected by adding enamel shade composite.

style italiano styleitaliano Line angles direct composite restoration diastema closure

Fig.9
Creating the line angles.

style italiano styleitaliano Finishing direct composite restoration diastema closure

Fig.10
Finishing the proximal area.

style italiano styleitaliano Final polishing direct composite restoration diastema closure

Fig.11
Final polishing with lucida polishing paste by Diashine.

style italiano styleitaliano Final situation direct composite restoration diastema closure

Fig.12
After finishing and polishing before final adjustment.

style italiano styleitaliano before and after direct composite restoration diastema closure

Fig.13
Before and after with split-dam.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.14
A photo with a black background to highlight the characterization of the anterior teeth.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.15
The patient returned for the second visit and expressed great satisfaction with the results.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.16
Inspect for any irregularities or sharp edges.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.17
Assess the symmetry.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.18
Change the angle of the flashes to see the textures.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.19
Capture a photo of your patient in a natural smiling position.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.20
Ensure that the restoration has been adequately polished to achieve durability.

style italiano styleitaliano final situation direct composite restoration diastema closure

Fig.21
Capture some artistic photographs showcasing the final restoration.

style italiano styleitaliano before and after direct composite restoration diastema closure

Fig.22
Capture before and after images from a side view and a close-up view to showcase the transformation achieved with the restoration.

style italiano styleitaliano before and after direct composite restoration diastema closure

Fig.23
Present the before and after images demonstrating the outcome of a minimally invasive procedure, highlighting the conservative approach of the treatment.

Conclusions

Adhesive direct restorations, employing composite materials, are integral to modern dental care, delivering precise and visually appealing results. The integration of LM Tools further elevates clinical efficiency, offering invaluable assistance throughout diverse dental procedures.

Bibliography

  1. Manuata J, Salat A. Layers, An atlas of composite resin stratification. , Quintessence Books, 2012. 3. Dietschi D. Optimizing smile composition and esthetics with resin composites and other conservative esthetic procedures.
  2. Hardan L, Bourgi R, Kharouf N, Mancino D, Zarow M, Jakubowicz N, Haikel Y, Cuevas-Suárez CE. Bond strength of universal adhesives to dentin: A systematic review and meta-analysis. Polymers. 2021 Mar 7;13(5):814.
  3. 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 Mar 1;5(1):102-24.
  4. Devoto W, Pansecchi D. Composite restorations in the anterior region: clinical and aesthetic performances. Practical Procedures & Aesthetic Dentistry: PPAD. 2007 Sep 1;19(8):465-70.
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