A two-step etch-and-rinse adhesive system was applied following manufacturer’s instructions over the prepared surface of #8 and the unprepared surfaces of #7. A first layer of dentin composite resin (UD 0.5) was used on #8 was applied over the cervical zone of the vestibular surface, and light-cured for five seconds. A universal enamel composite resin (UE2) was then applied all over the vestibular area until the tooth’s shape was completed, and light-cured under a small layer of glycerin gel for 60 seconds. UE2 alone was used for characterization and esthetic corrections on #7. At the same appointment, a first polishing was done using a diamond silicone point at 4,000 rpm.
The adhesive technique used on #8 and #7.
Dentin composite resin application.
Enamel composite resin application.
Final light-curing through the glycerin layer.
Definitive finishing and polishing procedures were performed 48 hours later. After drawing the transitional angles on the vestibular surfaces to mimic the visual effects of natural teeth, final shaping of the restored teeth was accomplished with abrasive discs.
Finishing procedure for definitive details; note the lines drawn to emulate the transitional angles of #9.
Diamond polishing pastes were applied in descending order of particle size using a goat hair brush. Final gloss was achieved using aluminium oxide paste with a felt wheel. Finally, interproximal surfaces were polished with diamond strips.
Diamond strips were used to polish the interproximal surfaces.
Immediately after finishing and polishing, showing a minimal difference in color.
One month later, the restorations are successfully integrated.
This case presents a conservative approach for the management of maxillary front teeth that have been functionally and esthetically impaired by an uncomplicated dental fracture, mismatched shades, and asymmetrical gingival zenith. Particularly interesting about this case was the integration of multiple conservative esthetic procedures. The direct freehand veneer played a fundamental role in achieving the right shape and color after the reattachment and the clinician was able to achieve optimized esthetics without laboratory procedures. When a case requires restoration of only one tooth it is easier to mimic the shape and color of the adjacent tooth and the need for subsequent adjustments is less likely. It should be noted, however, that even with these advantages, esthetic correction after fragment reattachment requires a clinician well trained in esthetic layering techniques.
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