Would you like to offer your patients predictable restorative treatments in the anterior region? Let us convince you that veneers are not the only option!
Prof. Paulo Monteiro, DMD, MSc
When a restoration is needed in the upper anterior region of a patient with particularly high aesthetic demands, many dental practitioners prefer indirect over direct restorative techniques. Reasons are a seemingly higher predictability and easier handling of the materials inside the mouth. However, it is possible to achieve beautiful results with little effort using direct composite materials as well – provided that the character of the tooth is analysed properly and a suitable material is selected. A possible technique that supports the dental practitioner in obtaining great treatment outcomes is illustrated below.
The small discoloured composite restoration on the upper right central incisor is visible and creates a disharmony in the overall picture. The proportion of the tooth is not ideal, either.
Analysis of the teeth’s character: The adjacent tooth shows different opacities including highly translucent areas on the incisal edge, but no intrinsic colours to be imitated.
Shade selection with two options A1 (left) and B1 of the VITA classical A1-D4 shade guide. According to the Styleitaliano recipes, the selected shade A1 is produced with 3M™ Filtek™ Supreme XTE Restoratives in the shades A1D (dentine) and A3E (enamel).
Checking the available space and the shape of the planned restoration with a silicone key.
Selective enamel etching of the prepared tooth structure.
Placement of the first palatal layer of composite in the Clear Translucent shade.
Vertical use of a posterior tooth matrix to restore the mesial interproximal wall with the shade A3E (enamel).
The dentine core is created and mamelons are added to copy the natural look of the left central incisor using the shade A1D (dentine).
Placement of a layer of composite in the shade Clear Translucent to lay the foundation for a uniform surface with 0.5 mm space left for the final enamel layer.
Situation prior to finishing and polishing.
High-gloss polishing with the pink spiral and water.
Restoration after the finishing and polishing procedure.
The restoration is beautiful, while the soft tissue needs some time to recover.
Treatment result several days after the treatment.
Beautiful smile of the young and pretty patient.
The described technique is easily taught and learned. It enables every dentist to obtain beautiful results despite a highly efficient procedure. However, these results are only achieved if high-quality materials are used and if the practitioner has developed a thorough understanding of the employed materials. Instead of magic, it is precise preparation and careful planning that leads to the desired, repeatable and therefore predictable outcomes loved by the patient.