PMC5081967_01
Preoperative intraoral view of the patient shows interdental spacing in maxillary anterior regions.
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fig1
Patient's medical history was noncontributory and intraoral examination using a Vernier Caliper (Aerospace Digital Vernier Caliper, India) revealed interdental spacing between maxillary central incisors (~4 mm) and maxillary central and lateral incisors (~1.5 mm) (Figures 1 -3).
Preoperative intraoral view of maxillary anterior regions.
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fig2
Patient's medical history was noncontributory and intraoral examination using a Vernier Caliper (Aerospace Digital Vernier Caliper, India) revealed interdental spacing between maxillary central incisors (~4 mm) and maxillary central and lateral incisors (~1.5 mm) (Figures 1 -3).
Preoperative extraoral view of the patient.
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fig3
Patient's medical history was noncontributory and intraoral examination using a Vernier Caliper (Aerospace Digital Vernier Caliper, India) revealed interdental spacing between maxillary central incisors (~4 mm) and maxillary central and lateral incisors (~1.5 mm) (Figures 1 -3).
(a) A small increment of composite is taken. (b) This increment is flattened with the instrument and is sculpted towards free gingival margin. (c) Composite is then thinned with a brush to achieve an imperceptible margin.
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fig4
Following this, a small increment was placed near the "future" contact area and manually contoured over the mesial surface using a long bladed titanium instrument (Figures 4(a) and 4(b)). A brush was then used to thin the material to obtain an imperceptible margin (Figure 4(c)).
Palodent matrix and mylar strip were applied for restoration of 21.
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fig5
Then, a contoured sectional matrix (Palodent  System, DENTSPLY Caulk, Milford, Delaware, US) was placed on the mesial surface of 21 with one end slightly into the sulcus (Figure 5). A mylar strip can be placed on the palatal aspect to act as a frame against which to pack composite (Figure 5).
Restoration of 11-matrix should be inserted slightly into the sulcus for correct emergence profile of the composite.
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The same procedure was repeated for 11 (Figures 6 and 7). Care should be taken to place the matrix slightly into the sulcus (Figure 6).
Anatomic contours can be easily achieved using the contoured matrix.
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fig7
The same procedure was repeated for 11 (Figures 6 and 7).
Finishing is done with an ET 9 bur.
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fig8
Once the midline diastema was restored, the diastema between central and lateral incisors was closed in the same manner. Once the diastema closure was accomplished in all the teeth, an ET 9 bur was used again for finishing procedure (Figure 8).
Labial view of upper anterior regions after diastema closure.
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fig9
Final outcome of the restorative procedure can be seen in Figures 9 -11.
Occlusal view after diastema closure.
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fig10
Final outcome of the restorative procedure can be seen in Figures 9 -11.
Postoperative extraoral view of the patient.
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fig11
Final outcome of the restorative procedure can be seen in Figures 9 -11.
View of the restorations at 14-month recall.
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fig12
At 14-month recall (Figure 12), the restorations were evaluated according to modified United States Public Health Service (USPHS) criteria.