FYLDNING

Aesthetic management of multiple diastema closures using a single shade composite

About the case

This male patient presented with chief complaint of spacing in his upper front teeth and desired improvements of the appearance of his teeth along with the closure of the diastemas.

Challenge

Aesthetic treatment of diastema closure presents a challenge in clinical practice. From a tooth perspective: managing the midline, symmetry and tooth proportions. On the other hand, from a treatment perspective how to stabilize the matrix and how to ensure a seamless blend of composite to enamel on the buccal surface, while simultaneously avoiding a greyish or overly opaque effect in the proximal spaces?

Outcome

The management of challenging cases can be greatly simplified thanks to the natural opacity and advanced properties of modern composites. These cases can often be successfully treated using a single-shade approach. A comprehensive technique for shaping and finishing ensures a natural appearance and optimal biological compatibility of direct composite restorations.

1. Initial situation: Patient presented with multiple diastema and demand to achieve natural looking teeth.

2. For tooth preparation a prepless approach was performed: The enamel surface was solely sandblasted and etched with phosphoric acid.

3. Trimmed silicon index based on wax-up to copy the incisal portion only. Allowing for simple transfer of information on symmetry and occlusion.

4. Preheated 3M™ Filtek™ Easy Match Universal Restorative Bright Shade was placed inside of the silicon index and positioned over the teeth and lightcured for 10 seconds each increment.

5. After removal of index: Incisal edges and occlusal guidance is transferred from the wax-up onto teeth.

6. After placement of Unica anterior matrix and the repeating of the adhesive step, 3M™ Filtek™ Easy Match Universal Restorative Bright Shade was applied to fill labial and proximal surfaces.

7. Excess removal and initial finishing with 3M™ Sof-Lex™ Contouring and Polishing Discs.

8. Once finalized the contouring 3M™ Sof-Lex™ Pre-Polishing Spiral was used to smooth the surface.

9. With the 3M™ Sof-Lex™ Diamond Polishing Spiral (add url to PDP) a final high-gloss surface was achieved.

10. Final restorations immediately after final polishing.

11. Four weeks post-op: perfect shade match due to naturally-adaptive opacity of 3M™ Filtek™ Easy Match Universal Restorative and healthy gingival margins.

12. Final smile effect: patient demanded natural appearance by closing only his multiple diastemas.