diastema composite

Style ItalianoAesthetic & restorative dentistryhttp://www.styleitaliano.org

Gaetano Paolone: Diastema Tips and Tricks 2

We are often asked to solve esthetic issues in anteriors where ideal conditions are missing.Diastemas and missing papillae compromise our restorative treatment plans. Mimicking ourrestorations in these unideal situations is not so easy.

An article by Gaetano Paolone,

Private practice, Rome, Italy

Publication, July 29th 2013

There are two main tips and tricks in this article, the first is to take advantage of the open cavityin order to gain access to a smaller one, the second and maybe the most important, is toprepare the case before the definitive restoration is done (hygiene, re-contouring).

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Fig 1.- Initial situation. The patient complains about esthetic issues aroud 2.1 and 2.2.

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Fig 2.- Colse-up of the initial situation, issues are related to an old restoration on 2.2, missingcontact point between 2.1 and 2.2. Distal surface of 2.1 has also a cavity.

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Fig 3.- One week before the appointment for the restoration, horizontal over-contour of 2.2restoration in noticeable and with an abrasive strip it will be re-contoured in order to let tissueheal.

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Fig 4.- In the time of just 1 week, the tissue is ready to receive a new restoration.

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Fig 5.- Dental dam is applied, and a dental floss is used to retract the soft tissues in order tohave better aces to the cervical area.

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Fig 6.- The old restoration is carefully removed.

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Fg 7.- The cavity is prepared.

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Fig 8.- Thanks to a silicone index, the palatal wall is layered.

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Fig 8.- The thin palatal wall with the choosen enamel of our stratification recipe.

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Fig 9.- The mesial surface is then restored with the same enamel (with the use of a convextransparent matrix as described in past articles: choose a matrix part 1, part 2, part 3, as well asthe dentinal body according to the recipe.

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Fig 10.- The restoration before finishing and polishing.

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Fig 11.- Two weeks recall.

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Fig 12.- Two weeks recall, close-up.

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Fig 13.- 26 months recall. Margin is noticeable (composite has worn a little and is opaque, butstill acceptable).

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Fig 14.- 26 months recall. Margin is noticeable (composite has worn a little and is opaque, butstill acceptable).

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