As we know, aesthetics is an increasing concern for our patients, particularly in anterior teeth. The current approaches to manage the esthetic demands include options such as prosthodontic rehabilitation, orthodontic treatment, and direct restorations.
Direct composite resin can offer an alternative to lab-fabricated all-ceramic materials, with aesthetic and functional results that can rival those of porcelain. Moreover, this can be accomplished in the least invasive way available in dentistry and at a lower price.
Thus, here in this post, I will discuss a case report (i.e., for which images are presented below) included aesthetic reshaping for the anterior segment by direct adhesive composite restorations:
1. Diagnosis and treatment planning
A 26-years-old female patient presented to my clinic for a consult regarding treatment options to regain the proper shapes of her front teeth. The patient (i.e., as she described) had long anterior teeth previously, and she visited a colleague dentist to solve this issue. However, the dentist did an aggressive grinding for her teeth to shorten them, which resulted in a reverse smile curve, and she was unhappy with the resuls. So, after discussing the treatment options, she decided to go for the aesthetic reshaping by direct composite restorations.
2. Pre-treatment steps
Images (facial, dentofacial, and retracted views) were captured first for 2D smile designing. Also, study models were fabricated from a maxillary and mandibular impressions that were mounted on a simi-adjustable articulator.
After that, anterior teeth wax-up was made according to the smile design, and in harmony with all functional movements of the mandible. Then, a silicone index was fabricated from the wax-up using vinyl polyvinylsiloxane impression materials because of their high reproduction of details and high final hardness.
3. Step-by-step clinical procedure
The clinical treatment steps are presented in the images below, with a simple description below each image.
Clinical note: In this case, the wax-up was made only for the central and lateral incisors. However, during the clinical procedure, I noticed that the canines were also needed some correction by composite materials to achieve better morphological shapes, and to provide better smile curve.
Finally, I would like to express my deepest gratitude to Dr. Ali Al-Qrimli ; the owner and CEO of “Digital IDEA” dental lab, with special thanks for the dental technician, Ali Kadum who did the wax-up for this case.
Best regards.
Dr. Mohammed Ali Fadhil
M.Sc., Ph.D., Restorative and Aesthetic Dentistry/Baghdad college of Dentistry.
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