Direct composite on composite crown

Cases - Semi directs - Direct anteriors
2016-07-18

The purpose of this article is to show a case where the dental and gingival aesthetics were involved. A periodontal treatment was performed aiming to health and gingival aesthetic and teeth were treated with direct composites and this is the main restorative material on this case, which gives treated teeth the same physical and optical properties under different light sources, thus avoiding metamerism phenomenon.

Fig. 1

Img. 1 – Initial view of the smile before the treatment.

Fig. 2

Img. 2 – Close-up view of the anterior teeth showing a fractured Class IV restoration on 1.1, a composite “veneer” on 2.1, a PFM crown on 2.2 and gum inflammation and retraction on this zone.

Fig. 3

Img. 3 – Close-up view of the “Veneer”, the PFM Crown and the gum condition.

Fig. 4

Img. 4 – The periodontal treatment was performed and a provisional crown was fit on 2.2.

Fig. 5

Img. 5 – Close-up view of the provisional and the gum.

Fig. 6

Img. 6 – A “transitonal” veneer was built on 2.1 after the old restorations removal. Note the aspect and gum profile.

Fig. 7

Img. 7 – Close-up aspect of the six anterior teeth.

Fig. 8

Img. 8 – A prepared composite resin crown was cemented in 2.2 position (U-200 3M) and all composite restorations were removed.

Fig. 9

Img. 9 – Aspect after blasting with aluminum oxide, etching and the adhesive application (Optibond – FL).

Fig. 10

Img. 10 – Palatal enamel and dentin stratification.

Fig. 11

Img. 11 – Removing of the dam and the retraction cords.

Fig. 12

Img. 12 – After a week, the geometry of the teeth were refined.

Fig. 13

Img. 13 – Secondary anatomy “map”.

Fig. 14

Img. 14 – Final aspect of the smile.

Fig. 15

Img. 15 – Palatal view of the incisal edge alignment before the treatment.

Fig. 16

Img. 16 – Palatal view of the incisal edge alignment, 6 months after the procedures.

Fig. 17

Img. 17 – Close-up view of the six anterior teeth, a little dehydratation can be noted on 1.2.

Fig. 18

Img. 18 – Black and white shot to evaluate the value balance.

Fig. 19

Img. 19 – Final aspect.

 

Conclusions
This article presents the versatility of application of composite resin, solving a common case in the daily practice. The knowledge of the material properties is very important for solving cases in a simple way, with actual results and benefits for the dentist and patient.