The patient is a 49 year old female who came into our office to see if “we can fix her two front teeth.” She recently completed orthodontic treatment and her dentist placed bonding on the two front teeth. She was upset with the outcome and after voicing her displeasure to her dentist, they said, “This is the best we can do.”
Upon examination and measuring the teeth, it was determined that the space was very large. I informed her that it would have been better if the orthodontist had closed the space between the two front teeth and opened the spaces distally to the centrals. Then we could have performed composite artistry to equalize the aesthetic effect of the anteriors. She was only interested in having the two centrals done. An impression was taken, a wax-up was done and a silicone putty matrix was constructed to use as a guide in the mouth. At the restorative appointment, local anesthetic was given, cord placed and the old composite carefully removed. The teeth were etched, bond placed and a lingual shelf placed using Vit-I-escence Pearl Frost. Because the space was large, Supreme Plus A2D was used for the dentin. The final layer of Durafill VS shade A-1 was placed extending over the facial surface of the tooth. The tooth was finished with polishing discs and burs to the completed contour and polish. The second tooth was completed in the same way but the final contact was done by pulling the microfill material into the contact area with a clear matrix strip as taught by Newton Fahl. The patient came back to the office for post-op check and final photographs.
