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Unesthetic restoration of a previously endodontically treated tooth

A clinical case by our Community member Dr. Muhammed Bahadeen

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.

A 13 year old male patient came to the office complaining of the poor aesthetics of the restoration on his upper left central incisor.

opaque composite restoration seen from the side style italiano styleitaliano

Fig.1
As seen from a lateral view, the restoration is short and opaque, and mismatched in color.

button try for composite color selection style italiano styleitaliano

Fig.2
Composite shades should be decided within 3 minutes to avoid error in shade selection due to tooth dehydration.

rubber dam isolation before incisor restoration style italiano styleitaliano

Fig.3
After complete removal of the old restoration the remaining tooth structure is too small to provide any kind of retention.

cementation of intra-canal fiber post styleitaliano style italiano

Fig.4
Thus a fiber post placement was necessary to reinforce the restoration.

spacing check with silicone index style italiano styleitaliano

Fig.5
A silicone index was previously prepared on the mock up for the patient. It was first used to check spacing for fiber post extra-coronal length and composite layering.

composite heating with spatula styleitaliano style italiano

Fig.6
Composite was heated to 68° C to enhance adaptation and handling of the composite.

palatal composite shell and fiber post style italiano styleitaliano

Fig.7
A palatal shell was created using a translucent enamel to give esthetic incisal translucency.

spacing between palatal composite shell and fiber post style italiano styleitaliano

Fig.8
Occlusal view shows space for layering.

polishing composite with lucida star felt style italiano styleitaliano

Fig.9
After finishing the restoration, the Lucida composite polishing system was used.

side view of composite restoration of upper left central incisor styleitaliano style italiano

Fig.10
Final result. Lateral view is to show the composite surface texture.

final result after composite restoration style italiano styleitaliano

Fig.11
Frontal view almost mimics the adjacent central incisor.

Conclusions

For patients under the age of 18, anatomical landmarks creation on the restoration is crucial because the natural teeth are not worn out due to long term subjections of certain foods and beverages and age related anatomical changes. Thus the restoration should mimic the adjacent tooth as much as possible.

Bibliography

1. Manauta J, Salat A. Layers: An Atlas of Composite Resin Stratification. 2012 Quintessence Pub
2. Bolat M, Stoleriu S, Iovan Vv, Pancu G, Sandu Av, Taraboanta I. Comparative Study of Color Stability of Three Composite Materials, Treated by Finishing and Coated Sealing, After Immersion in Different Wholesale. Revista De Chimie. 2019;70:1681–4

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