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CDEN0109

I 31 industry report _ veneers & composites I cosmeticdentistry 1_2009 If existing restorations demonstrate an acceptable shade and tight restoration margins, repairing them is oftenthebestsolution. Relative isolation may be sufficient in conjunction with cosmetic treatment in the anterior region. In the presentcase,untreatedretractioncordswereused. Twopointshavetobeconsideredwhenrestoringan- teriorteethwithcompositematerials:first,therestora- tivetreatmentshouldstartwiththecentralincisors,and second,thecentralincisorthatshowstheleastdamage, i.e.isclosesttotheidealfinalresult,shouldberestored first.Restoringseveralteethsimultaneouslymayleadto problemsintheproximalregion,suchasinappropriate proximalcontactareas. The prepared surfaces were etched for 30 seconds usingthetotaletchtechnique.Next,TetricN-Bondwas applied and light-cured for 20 seconds (Fig. 2). If a sili- cone key is sited, composite stratification is started in thepalatalarea,forwhichatranslucentshadeisutilised. In the present case, Bleach I (Tetric N-Ceram) was applied.Thecompositewasplacedinaverythinlayerin order not to impair the subsequent reconstruction of the incisal edge (Fig. 3). After the material was light- curedfor20seconds,thedentincorewasrebuiltusing ashadethatofferedanappropriatelevelofopacityand saturation. In the present case, Tetric N-Ceram A3.5 Dentin was applied and light-cured for 20 seconds. An opaquehaloeffectresulted.Thisthinvisiblelineispro- ducedregardlessofthepatient’sageordegreeoftooth abrasion.Thehaloeffectiscausedbythevariationinthe arrangement of vestibular and lingual enamel prisms. For this purpose, Tetric N-Ceram in shade A3.5 Dentin wasutilised.Thesameshadewasalsousedtorebuildthe dentin body. Since this material was applied in only a thinlayer,light-curingfor20secondswassufficientto achieveanoptimumdepthofcure. Next, the incisal effects were recreated using BleachI(Fig.4).Thesameshadewasusedfortherecon- structionofthepalatalsurfaces.Thismaterialprovides a slightly bluish translucent effect and thereby en- hancesthedegreeoftranslucencyandaccentuationin this area. After the incisal and palatal surfaces were rebuilt, Tetric N-Ceram A2 was applied to the entire surface in the vestibular region. The material was appliedinslightlythinnerlayersinthemarginalandin- cisalareas,tosavespacefortheapplicationofanincisal material with a higher degree of translucency. This method enhances the passage of light and slightly re- ducesthecoloursaturationofthebasicmaterial.Here, TetricN-CeramTwasutilisedforthispurpose. Before final light-curing, the composite surfaces should be covered with a thin layer of glycerine to pre- venttheformationofanoxygen-inhibitedlayerandto Fig. 2_Tetric N-Bond adhesive is applied to the central incisor after etching with phosphoric acid. Fig. 3_The incisal edge is built up with translucent composite material (Tetric N-Ceram Bleach Incisal) with the help of a silicone key, which has been fabricated based on the wax- up. After this layer has been light- cured, dentin material (Tetric N-Ceram A3.5 Dentin) is applied. Fig. 4_After special effects have been applied, the incisal edge is rebuilt using a specially designed spatula (OptraSculpt). Fig. 5_After the first incisor has been built up, the proximal contact areas are roughly contoured to facilitate the subsequent re-establishment of adequate contact areas. Fig. 6_The same procedure is used to build up the other teeth. After restoring the central incisors, the lateral incisors and canines are reconstructed. Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6