Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Flavia Pardo Salata Nahsan, Rafael Francisco Lia Mondelli, Eduardo Batista Franco, Fabiana Scarparo Naufel, Julio Katuhide Ueda, Vera Lucia Schmitt, Wagner Baseggio, Flavia Pardo Salata Nahsan, Rafael Francisco Lia Mondelli, Eduardo Batista Franco, Fabiana Scarparo Naufel, Julio Katuhide Ueda, Vera Lucia Schmitt, Wagner Baseggio

Abstract

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Figures

Figure 1
Figure 1
Initial case, showing inadequate reproduction of the polychromatic aspects of tooth
Figure 2
Figure 2
Initial radiograph, showing satisfactory endodontic treatment
Figure 3
Figure 3
Shade selection performed on a clean tooth under the natural humidity, with a large combination of composite resins attempting to identify the fine shade differences at each tooth region
Figure 4
Figure 4
Artificial palatal enamel made using a silicon personalized guide
Figure 5
Figure 5
Application of translucent resin to reproduce the palatal portion of the tooth. Note the translucency achieved by Amaris® TL, ideal to reproduce the enamel that was lost
Figure 6
Figure 6
Reproduction of the deepest artificial dentin with more opaque characteristics
Figure 7
Figure 7
Application of Amaris® O1 to reproduce a more superficial dentin
Figure 8
Figure 8
Application of Amaris® TL+high opaque to mimic the effect of opalescent halo. Amaris® HT was inserted to reproduce the incisal translucency
Figure 9
Figure 9
Application of Amaris® TN over the other shades, reproducing the buccal enamel
Figure 10
Figure 10
Final esthetic outcome
Figure 11
Figure 11
Follow-up at 12 months

References

    1. Araujo EM, Jr, Baratieri LN, Monteiro S, Jr, Vieira LC, Andrada MA. Direct adhesive restoration of anterior teeth: part 2. Clinical protocol. Pract Proced Aesthet Dent. 2003;15(5):351–357.
    1. Baratieri LN, Araujo E, Monteiro S., Jr Color in natural teeth and direct resin composite restorations: essential aspects. Eur J Esthet Dent. 2007;2(2):172–186.
    1. Blank JT. Creating translucent edge effects and maverick internal tints using microhybrid resin. Pract Proced Aesthet Dent. 2006;18(2):131–136.
    1. Brodbelt RHW, O'Brien WJ, Fan PL. Translucency of dental porcelains. J Dent Res. 1980;59:70–75.
    1. Dietschi D. Free-hand composite resin restorations: a key to anterior aesthetics. Pract Periodontics Aesthet Dent. 1995;7(7):15–25.
    1. Dietschi D. Optimising aesthetics and facilitating clinical application of free-hand bonding using the "natural layering concept". Br Dent J. 2008;204(4):181–185.
    1. Dietschi D, Ardu S, Krejci I. A new shading concept based on natural tooth color applied to direct composite restorations. Quintessence Int. 2006;37(2):91–102.
    1. Franco EB, Francischone CE, Medina-Valdivia JR, Baseggio W. Reproducing the natural aspects of dental tissues with resin composites in proximoincisal restorations. Quint Int. 2007;38:505–510.
    1. Lopes LG, Franco EB, Pereira JC, Mondelli RFL. Effect of lightcuring units and activation mode on polymerization shrinkage and shrinkage stress of composite resins. J Appl Oral Sci. 2008;16(1):35–42.
    1. Magne P, Holz J. Stratification of composite restorations: systematic and durable replication of natural aesthetics. Pract Periodontics Aesthet Dent. 1996;8(1):61–68.
    1. Marus R. Treatment planning and smile design using composite resin. Pract Proced Aesthet Dent. 2006;18(4):235–241.
    1. Ozel E, Kazandag MK, Soyman M, Bayirli G. Two-year follow-up of fractured anterior teeth restored with direct composite resin: report of three cases. Dent Traumatol. 2008;24(5):589–592.
    1. Peyton JH. Direct restoration of anterior teeth: review of the clinical technique and case presentation. Pract Proced Aesthet Dent. 2002;14(3):203–210.
    1. Portalier L. Diagnostic use of composite in anterior aesthetics. Pract Periodontics Aesthet Dent. 1996;8(7):643–652.
    1. Terry DA. Color matching with composite resin: a synchronized shade comparision. Pract Proced Aesthet Dent. 2003;15(7):515–521.
    1. Terry DA. Dimensions of color: creating high-diffusion layers with composite resin. Compend Contin Educ Dent. 2003;24:3–13.
    1. Vanini L. Light and color in anterior composite restorations. Pract Periodontics Aesthet Dent. 1996;8(7):673–682.

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