Smile rejuvenation using minimal invasive techniques

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 field of restorative dentistry, advancements in materials and equipment, such as adhesive systems, composite resins, spatulas, and brushes, have significantly streamlined dental procedures and enhanced patient treatments. However, despite these advancements, many practitioners find composite resin procedures in the anterior sector to be complex and time-consuming. Achieving a durable, virtually undetectable restoration within a reasonable timeframe remains a common challenge for dentists. This article aims to illustrate that by employing the principle of task division in restorative dentistry, designing composite resin restorations in the anterior sector can be simplified into a series of straightforward and replicable steps. By following a well-defined timeline and executing each step meticulously, predictable and satisfactory results can be achieved.

styleitaliano style italiano initial situation diastema smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.1
A 27-year-old lady visited the clinic seeking a solution for her diastema and short teeth. She expressed a desire for a brighter and more prominent smile.

styleitaliano style italiano Initial photoghraph smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.2
In a lateral view, the diastema (gap between teeth) and smile line (the curve formed by the upper edge of the lower lip during a smile) can be determined and measured.

styleitaliano style italiano diastema frontal view smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.3
Complications can be observed in front of the patient.

styleitaliano style italiano diastema frontal view with black background smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.4
To enhance visibility of the incisal edges, you can create a black background.

styleitaliano style italiano isolation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.5
Using Mobile Dental Photography for recording the steps.

styleitaliano style italiano isolation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.6
Inspect the rubber dam placement from a palatal view to ensure there are no spaces or gaps.

styleitaliano style italiano brush and modeling liquid for composite placement smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.7
Utilize the composite brush and modeling liquid (GC, Tokyo, Japan) for precise adaptation of composites.

styleitaliano style italiano mamelons creation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.8
Employ an LM Arte fissura (LM, powered by Styleitaliano) to enhance the visibility and narrow the mamelons.

styleitaliano style italiano mamelons creation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.9
Ensure the mamelons’ lengths are uniform, utilizing A1 LS (Shofu, Kyoto, Japan) as a dentin shade to achieve harmonious blending.

styleitaliano style italiano composite placement smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.10
Utilize the LM Arte Modella (LM, powered by Styleitaliano) instrument to accurately set the composite on the facial surface.

styleitaliano style italiano frontal view of palatal walls smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.11
Develop the translucent zone with ECC and OBN.

styleitaliano style italiano composite placement smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.12
Creating the incisal halo with injectable BW (Shofu, Kyoto, Japan).

styleitaliano style italiano composite placement smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.13
Examine the thickness of layers from a lateral view.

styleitaliano style italiano composite placement diastema closure smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.14
Employ transparent strips to effectively close the diastema.

styleitaliano style italiano shaping stage smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.15
During the shaping step, address any depressions and irregularities, utilizing HVT (Shofu, Kyoto, Japan) as an enamel shade for precise correction.

styleitaliano style italiano final situation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.16
To prevent tearing of the rubber dam and ensure a clean working environment, carefully handle the rubber dam during placement and removal, use appropriate clamps and techniques to secure it in place.

styleitaliano style italiano final situation smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.17
Consistently rehydrate the tooth throughout the procedure to maintain its moisture balance and prevent desiccation.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.18
Utilize the Jotta Twinkle polishing system for achieving a polished finish.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.19
Create a black background to enhance visibility of translucent areas.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.20
Modify the incisal edges, shapes, and characterization as needed.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.21
The upper teeth should align with or adhere to the vermilion border of the lower lip for optimal aesthetic harmony.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.22
Craft irregular textures as desired to add natural variation and aesthetic appeal.

styleitaliano style italiano final result smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.23
Observe the patient’s teeth during smiling and speaking to assess their appearance and functionality in dynamic situations.

styleitaliano style italiano before and after smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.24
Inspect in a macro view to closely examine details and ensure precision.

styleitaliano style italiano before and after smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.25
The noticeable difference was evident, and the patient expressed satisfaction with the final outcome.

styleitaliano style italiano before and after smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.26
Correct the occlusion to ensure proper alignment and function of the teeth.

styleitaliano style italiano before and after smile rejuvenation using minimal invasive techniques direct composite veneers

Fig.27
Compare the before and after results in a lateral view to assess the changes and improvements.

Conclusions

Adhesive direct restorations, employing composite materials, play a vital role in dental care by providing precise and aesthetically pleasing outcomes. The incorporation of LM Tools significantly enhances clinical efficiency, providing essential assistance across various dental procedures.

Bibliography

  1. 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.
  2. HardanL, 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. 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.
  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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