Discussion

With regard to the stratification of the microfill material over the microhybrid layer, the former was layered over the facial surface of the latter to completely cover the tooth. This, as the microfill would wear over time, will reduce the potential of any stain from showing at the margin of the composite. This final microfill layer has excellent polishing characteristics and can be easily repolished over time as necessary. Nevertheless, care should be taken at succeeding hygiene visits to avoid dulling of the surface with the use of more abrasive prophy polishing pastes.

During the resin build-up, it is important to step way from the paitent, to look at her face, and to ensure that the first restoration exhibits proper alignment both axially and faciolingually. The relative length and the general esthetics – compared to the other dentition – should also be observed. The final determination of shade compatibility did not occur for approximately 24 hours due to dehydration of the teeth.

After a period of evaluation, the mandibular dentition was enhanced in the same manner as was the maxillary arch. No natural tooth structure was removed, and the process of creating these new shapes with composite resins permits their removal at a future date if the patient decides to proceed with both orthodontics and orthognathic surgery. On the other hand, this conservative approach also leaves open the option of replacing these restorations with almost no damage to the existing underlying natural dentition.

Conclusion

As demonstrated herein, using the combination of bleaching and direct composite resin restorations, it was possible to provide conservative correction of the patient’s anterior dentition. This was enabled in part by state-of-the-art materials with excellent optical and handling characteristics. When used chairside with adequate understanding of tooth morphology, adhesive bonding, and the handling of the material itself, these resins can be used to create conservative and esthetic restorations that can be placed in one appointment with no anesthesia.

Dr Rhys Spoor DDS Aesthetic & Restorative Dentistry - Providing services in cosmetic and sleep dentistry to the area of Seattle, Washington.

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