Interproximal resto tools: make your diastema predictable
19456 Views - May 2017Download PDF
Closing diastemas with a direct technique might seem quite unpredictable; composite resins allow a very conservative treatment that provides us with very natural results, and without removing natural sound tissues. Actual composite resins allow us to mimic natural teeth even when they have been previously bleached. In this clinical case we are going to show some tips and tricks to use anterior matrix and how to get the best out of this kind of treatment.
Img. 1 - Initial situation of the patient. 50 old year woman comes asking for an esthetic and conservative result
Img. 2 - In the first appointment we shoot videos, extraoral, intraoral photos and take impressions for the study cast
Img. 3 - Photographs allow us to obtain a lot of information that normally we don't see during a quick examination of the patient
Img. 4 - We like to take photographs from different angles to obtain as much information as possible.
Img. 5 - All of this information is a great tool to communicate with the patient
Img. 6 - After a DSD analysis we proceed to make the mock-up
Img. 7 - We show the mock-up to the patient, as it is the best way to communicaticating the final result in a realistic manner
Img. 8 - Here are some tips to make your mock-up a piece of cake!
Img. 9 - After having seen the mock-up, the patient accepts the treatment plan
Img. 10 - We start with our bleaching protocol (White Dental Beauty)
Img. 11 - After the result is appropriate for the patient we go through the restorative phase
Img. 12 - TIP: We wait at least 2 o 3 weeks after the whitening to start the adhesive procedures
Img. 13 - We think isolation is the only way to manage these cases
Img. 14 - Having the field isolated allows us a better vision and have no influence of the saliva
Img. 15 - We simply eliminate the aprismatic enamel with a soflex disc
Img. 16 - We then clean the surface with glycine powder
Img. 17 - Until everything is really clean
Img. 18 - Now we proceed with the etching phase
Img. 19 - Going far away in the enamel
Img. 20 - And wash it thoroughly
Img. 21 - We need to be sure that everything is clean and then dry (MDP PHOTO)
Img. 22 - In this case we use a universal adhesive (MDP PHOTO)
Img. 23 - We polymerize the adhesive 10 sec from different directions
Img. 24 - And we start with the palatal enamel
Img. 25 - With the help of the applica instrument (LM Arte)
Img. 26 - After removing the index
Img. 27 - We use a posterir matrix (Polydentia) to imitate the emergence profile
Img. 28 - My Custom Rings Kit by Style Italiano (Polydentia) contains everything you might want to use for interproximal modelling.
Img. 29 - TIP: Liquid dam is a great tool to mantain the matrix in place.
Img. 30 - After removing the matrix, the proximal wall is made.
Img. 31 - We apply the mass and smoothen it with a brush
Img. 32 - Thanks to the Misura instrument, we respect the 0,5 mm for the thickness of enamel
Img. 33 - And we finish with the appropiate enamel
Img. 34 - First we finish one tooth
Img. 35 - We remove the excess material with the Eccesso (LMArte) spatula
Img. 36 - And we continue with the next tooth
Img. 37 - Repeating the same procedure
Img. 38 - Then we go through the finishing and polishing procedures
Img. 39 - Discs and burs are used
Img. 40 - Immediate result after removing the rubber dam
Img. 41 - We need to wait for the healing of the soft tissues and rehydration of the teeth and their restorations.
Img. 42 - Final lateral smile, one week after
Img. 43 - From the other side
Img. 44 - Frontal photo
Img. 45 - Polarized photos allow us to check the color of the restoration
Img. 46 - Different views
Img. 47 - From all the angles
Img. 49 - And final smile
Img. 50 - The whole procedure took us
Img. 51 - 1 hour and 46 min
ConclusionsComposite resins used with a direct technique is the most conservative option to solve esthetic problems in a very good way. Additionally, a whole set of tools have been brought to the market to make it even easier. This article has shown how these cases can become predictable and easily manageable.
- Devoto W, Saracinelli M., Manauta J. Composite in everyday practice: how to choose the right material and simplify application techniques in the anterior teeth. Eur. J. Esthet Dent 2010; 5: 102-Vanini L. Mangani F. Klimovskaia O. Conservative Restoration of Anterior Teeth. Acme, 2005
- Baratieri LN., Araujo Jr E.M. Monteiro Jr S. Composite Restorations in Anterior Teeth: Fundamentals and Possibilities. Quintessence Books
- Dietschi D. Layering concepts in anterior composite Restorations. J. Adhes Dent 2001; 3: 71-80