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Aesthetic dentistry section

ROADMAP TO SEAMLESS

ANTERIOR RESTORATIONS

Sanah Sayed

OVERVIEW
Composite dental materials are a versatile and widely used class
of restorative materials in modern dentistry. These materials are
composed of a mixture of organic polymers, inorganic filler particles
and various additives allowing them to be tailored to specific clinical
applications.
In this article, we will discuss the case of a 29-year-old male patient
with a history of childhood trauma. The tooth was not symptomatic
but he wanted to get it treated since he was getting married and the
tooth was bothering him when smiling for photographs. Fig 1a: Pre operative situation

Material choice: Composites have come a long way. The earlier
reported shortcomings of resin have received a face lift by
improvements in chemical composition and technical
advancements causing lesser polymerization shrinkage
stress, better mechanical properties, wear resistance and
retention of esthetic qualities. For this particular case I have
used Topaz restorative line up (Kulzer, Germany) which is a
BPA free, TCD-urethane based composite (nanohybrid). The
advantage of using this composite is that it offers good handling
properties without the need for diluents like in conventional BisGma
based composites thus, reducing shrinkage and allowing more
monomers to convert into polymer chains due to the reactivity of the
double bonds (urethane).
Fig 1b: Restorative plan to mimic adjacent central incisor
SEAMLESS RESTORATION
The three key pillars of a perfectly integrated seamless restoration are:
Shape – Shape precedes over all other factors. Mimicking mamelons
in a young patient or a worn incisal edge shape in an elderly patient
are major factors that contribute to blending of the restoration with
the rest of the dentition.
Shade – Shade is composed of hue, chroma and value. VALUE BASED
dentistry is more important than chroma since opacity differences are
appreciated easily by the human eye making the patient aware about
the brightness or dullness of the restoration.
Surface texture – Light scattering effects are altered due to the surface
texture. Young patients with tertiary characteristics will scatter and
reflect light more than elderly patients with smooth worn-out textures
due to wear and tear of enamel. Here my patient exhibits a highly
characterized and textured tooth with incisal characteristics including
translucency, halo, amber characteristics and white diffuse intensives Fig 2: Pre operative situation. Restricted restorative space and
making the case challenging and exciting at the same time. premature contact on the mandibular lateral incisor.

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22 Dental Practice I March-April 2024 I Vol 20 No 2