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Hossam Hamza

Orthodontist

Composite-Resin Fillings combined with Ceramics after Periodontal Treatment and Teeth Whitening for Smile Remodeling

This is a case report by Dr Leonardo Fernandes da Cunha et al. Female patient (20 years old) complained of the shape, staining and fractures of composite resin fillings in upper anterior teeth. Clinical examination and X-ray revealed a composite resin on 22, a prosthetic implant on 12 and hypoplastic staining of 11, 21 and upper/lower canines. Gum arch was irregular but gingival inflammation was not observed. Composite filling on 22 had inadequate width-to-height ratio. Treatment started with gum scaling and prophylaxis, followed by hydrogen-peroxide in-office bleaching and gum contouring using electric scalpel. Then, crown on 21 was replaced by provisional bisacrylic-resin crown (Structur 3, Voco, Cuxhaven, Germany), while central incisors and canines as well as tooth 22 were restored with Amaris resin (Voco, Cuxhaven, Germany). Finally, provisional crown on 21 was replaced with E.max porcelain crown.

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Preoperative front view of the smile
Preoperative view of the smile from lateral side
Rest position of the lips: notice excess opacity of the prosthesis on the implant on 12
Preoperative front view showing unbalanced maxillary gingival arch
Preoperative lateral view of the smile showing unsatisfactory composite resin filling on the 22
Model with diagnostic wax-up with more detailed triangular contour of the labial proximal edges
Probing after initial gum scaling and prophylactic treatment
Smile line marked with dental floss
Gum recontouring was done with electric scalpel on the right side
A photo was taken immediately after gingivoplasty
Hydrogen-peroxide for office bleaching
Shade selection with VITA 3D Master scale after anatomical recontouring of teeth using composite filling (Amaris) and temporary restoration with bisacrylic resin (Structur 3)
Die model prepared for reinforced ceramic with lithium disilicate (shade BL4)
External aspect of porcelain crown after finishing
Internal aspect of ceramic on the microdont tooth after finishing
On removal of temporary crown on 12 no soft tissue inflammation occurred which denotes adequate adaptation of the provisional crown
Postoperative front view of composite-resin fillings combined with porcelain crown on 12
Postoperative lateral view showing the details of resin restorations combined with ceramics
Postoperative frontal view of the patient's final smile
Postoperative lateral view of the smile
Final view of teeth with resting lips showing improved translucency of the crown over the implant on 12
Avatar
Hossam Hamza

Orthodontist

Composite-Resin Fillings combined with Ceramics after Periodontal Treatment and Teeth Whitening for Smile Remodeling

This is a case report by Dr Leonardo Fernandes da Cunha et al. Female patient (20 years old) complained of the shape, staining and fractures of composite resin fillings in upper anterior teeth. Clinical examination and X-ray revealed a composite resin on 22, a prosthetic implant on 12 and hypoplastic staining of 11, 21 and upper/lower canines. Gum arch was irregular but gingival inflammation was not observed. Composite filling on 22 had inadequate width-to-height ratio. Treatment started with gum scaling and prophylaxis, followed by hydrogen-peroxide in-office bleaching and gum contouring using electric scalpel. Then, crown on 21 was replaced by provisional bisacrylic-resin crown (Structur 3, Voco, Cuxhaven, Germany), while central incisors and canines as well as tooth 22 were restored with Amaris resin (Voco, Cuxhaven, Germany). Finally, provisional crown on 21 was replaced with E.max porcelain crown.

Please rate this case
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