Improper contacts in anterior restorations can lead to aesthetic and functional issues, necessitating the replacement of the restoration. Ensuring proper restoration and correct contact points is crucial in such cases. To achieve excellent aesthetics, especially concerning color in the anterior region, complete removal of the restoration may be necessary.
Before starting the treatment, the position of the midline and incisal edges was determined using digital photographs. Aligning the midline and the incisal edges of anterior teeth according to the smile line is extremely important for aesthetics.
Rubber dam ( Nic Tone, Bucharest, Romania) was applied using split dam technique. Subsequently, the old restorations were removed using a diamond flat end cylinder bur. Beveling was done using a flame-shaped bur.
37% orthophosphoric acid was applied using the selective etch technique. Then, universal bond (Prime & Bond, Dentsply Sirona, North Carolina, USA) was applied according to the user instructions.
Palatal shells were created using the free-hand technique with Mylar matrix. Enamel composite ( GC Essentia LE, Tokyo, Japan) was used.
Interproximal walls were created with Mylar matrix using the enamel composite. Then, dentin (GC Essentia MD) was applied. To reduce the visibility of the fracture line, it was thoroughly rubbed in using a composite modeling brush (GC Corp.) . Subsequently, dentin mamelons were created using LM Arte Fissura.
The final layer was finished with enamel composite. The teeth appear more opaque due to dehydration compared to the composite. The patient was scheduled for a follow-up appointment.
After rehydration, color looks more harmonious.
CONCLUSIONS
1.Planning treatment on digital photographs increases predictability.
2.If the color selection was done before dehydration, the color harmony tends to be better at the end of the treatment.
BIBLIOGRAPHY
1. Signori C, Collares K, Cumerlato CBF, Correa MB, Opdam NJM, Cenci MS. Validation of assessment of intraoral digital photography for evaluation of dental restorations in clinical research. J Dent. 2018 Apr;71:54-60. doi: 10.1016/j.jdent.2018.02.001. Epub 2018 Feb 10. PMID: 29438796.
2. Alamé C, Mehanna Zogheib C. The Effect of Dehydration on Tooth Color: A Prospective In Vivo Study. Cureus. 2023 Nov 2;15(11):e48140. doi: 10.7759/cureus.48140. PMID: 38046777; PMCID: PMC10692694.
3. Riquieri, H, 2019, Dental Anatomy and Morphology (page:254), Quintessence Publishing, USA
Initial situation
The position of the midline and incisal edges was determined using digital photographs.
The old restorations were removed using a diamond flat end cylinder bur.
37% orthophosphoric acid was applied using the selective etch technique. Then, universal bond (Prime & Bond, Dentsply Sirona, North Carolina, USA) was applied according to the user instructions.
Palatal shells were created using the free-hand technique with Mylar matrix.
Interproximal walls were created with Mylar matrix using the enamel composite. Then, dentin (GC Essentia MD) was applied.
Immediate after
1 week
After rehydration, color looks more harmonious.
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