wide diastema between central incisors

Using the Front Wing Technique

A clinical cases by our Community member Dr Matthias Kuhn.

 

Minimally invasive dentistry contains a variety of treatment options to restore lost tooth structures or even construct new tooth shapes. An additive restoration concept, in combination with composite or ceramic restorations, secures the protection of tooth structure. The preferences of the dentist determines the choice of the restoration material. In this case a direct resin composite restoration was chosen to close a diastema between 11 and 21.

occlusal view showing multiple cavities

Fig.1

Occlusal view before treatment. Multiple caries and lesions are visible.

rubber dam isolation of diastema

Fig.2

The initial situation after application of the rubber dam.

cleaning with pumice paste of sound buccal and proximal surfaces

Fig.3

Cleaning of the surfaces.

etched enamel on central incisors

Fig.4

Situation after surface conditioning with 35% phosphoric acid.

front wing build up

Fig.5

Application of the front wings with Filtek supreme Body A3,5 (3M).

sectional matrices and wooden wedges for diastema closure

Fig.6

Application of the sectional matrices and wedges.

composite restorations before finishing and polishing

Fig.7

Frontal contour of 11, 21 after removal of the matrices. There is a slight cervical contour deficit on 11.

line angle design for diastema direct restoration

Fig.8

Marking the primary anatomy.

occlusal view after diastema closure

Fig.9

Occlusal view after completion of all restorations and before starting the finishing procedure.

central diastema closed with direct composite restorations

Fig.10

After the first surface treatment, I noticed the contour deficit on 11 and I added a small amount of composite in the cervical area.

composite restorations before polishing

Fig.11

Situation after removal of the rubber dam.

polished composite diastema closures

Fig.12

The final picture at the end of the first appointment.

glossy composite restorations

Fig.13

Frontal view after one week. There was no need to polish the restorations again, as they showed a good integration.

side view for surface texture of composite diastema closure

Fig.14

Lateral view after one week.

composite restorations on central incisors after six months

Fig.15

Situation after 6 months. Please note the migrated papilla.

Conclusions

The Front Wing Technique is a precise way to close a diastema because of its workflow and the good control of the aspired emergence profile.

Bibliography

1. Manauta J. The Front Wing Technique. 2016. Styleitaliano. https://www.styleitaliano.org/the-front-wing-technique/

2. Manauta J, Salat A. Layers, An atlas of composite resin stratification.Quintessence Books, 2012

3. Dietschi D, Argente A. A comprehensive and conservative approach for the restoration of abrasion and erosion. part II: clinical procedures and case report. Eur J Esthet Dent. 2011;6(2):142-159.

4. Dietschi D, Argente A. A comprehensive and conservative approach for the restoration of abrasion and erosion. Part I: concepts and clinical rationale for early intervention using adhesive techniques. Eur J Esthet Dent. 2011;6(1):20-33.

5. Browet S, Gerdolle D. Precision and security in restorative dentistry: the synergy of isolation and magnification. Int J Esthet Dent. 2017;12(2):172-185.