PMC6558625_01
Restored right maxillary central incisor showing poor color match. The restoration of the fractured tooth extended to the middle third.
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fig1
The existing restoration had a poor color match and excess material (Figure 1).
Selection of color before tooth dehydration. The two enamel colors of the system were initially tested (LE and DE) (a). Then, the three dentin colors were tested (LD, MD, and DD) (b).
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fig2
For enamel color selection, each of the two enamel colors (light enamel and dark enamel) were placed on the tooth and polymerized (Figure 2(a)). Light dentin was selected (Figure 2(b)).
Removing the existing restoration with abrasive disks. A beveled margin was made with coarse grit disks to remove the unsupported enamel.
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fig3
A beveled margin was made with the same disk (Figure 3).
Rubber dam isolation of the operative field (a) and application of the adhesive system and polymerization according to the manufacturer's instructions (b, c).
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fig4
The operative field was isolated and the gingiva displaced with ligated rubber dam (Figure 4(a)). The enamel surface was conditioned with 37% phosphoric acid (Figure 4(b)), and the adhesive (G-BOND, GC) was then applied on the facial and lingual surfaces (Figure 4(c)) and polymerized according to the manufacturer's instructions.
A silicone guide was used to assist the restoration of the lingual surface with the light enamel composite resin (LE: light enamel, Essentia, GC).
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fig5
The silicone matrix was positioned lingually to provide a well-contoured restoration (Figure 5(a)).
Facial (a), lateral (b), and incisal (c) views immediately after application and polymerization of the resin to form the lingual "shell" with enamel resin.
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fig6
After polymerization of this increment with the matrix in position, the lingual and incisal contour was established (Figure 6).
LD (light dentin; Essentia, GC) resin, corresponding to the dentin region, was then applied.
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fig7
Dentin resin was then applied to the middle third (LD), leaving room for the creation of a dentinal lobe in the incisal region (Figure 7).
A resin with greater OM opalescence was placed to characterize the incisal area (a-c).
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fig8
The incisal halo was made by using the opalescent translucent resin of the OM system (Figure 8), followed by a layer of white stain on that halo to simulate the opacity of this region (Figure 9).
Brush application of the white stain (Essentia, white modifier) to characterize the opaque incisal halo (a, b).
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fig9
The incisal halo was made by using the opalescent translucent resin of the OM system (Figure 8), followed by a layer of white stain on that halo to simulate the opacity of this region (Figure 9).
Application of LD dentin resin up to approximately half the width of the bevel. Observe the spaces between the developmental lobes, left when applying the opaque resin, in which the translucent incisal resin (OM) will be placed.
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fig10
The dentin mamelons were made with clear resin (Figure 10), and opalescent resin was applied between the mamelons (Figure 11(a)).
Insertion of translucent incisal resin (OM) between dentin mamelons (a). Then, the resin was applied in the LE color over the entire facial surface of the restoration to simulate the enamel (b).
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fig11
The dentin mamelons were made with clear resin (Figure 10), and opalescent resin was applied between the mamelons (Figure 11(a)). The enamel layer was applied to the facial surface and spread with the aid of a polyester strip and brush (Kota 4A) (Figure 11(b)).
Finishing and polishing of the restoration with abrasive disks (a), fine diamond rotary instruments (b, c), rubber points (d), and a felt disk with polishing paste (e).
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fig12
Rubber points and composite polishing paste applied with a felt disk were used to obtain the final gloss (Figure 12).
Detail of restorations after finishing and polishing procedures (a-c).
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fig13
The final restoration can be seen in Figures 13(a) and 13(b).
Smile view, harmony of shape, color, and function of the tooth have been restored (a, b).
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fig14
The definitive appearance of the restored smile can be seen in Figure 14.