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CDE0111

I 19 case report _ aesthetics & function I cosmeticdentistry 1_2011 This article seeks to demonstrate the manner in which the goals of an orthodontic treatment were fulfilled in a clinical case. A multidisciplinary ap- proach is indispensable for the achievement of the therapeutic goals of functionality and aesthetics, whichareobtainedthankstomoderndirectrestora- tive dentistry as part of a comprehensive treatment plan and followed by an aesthetic and functional execution of that plan. _Case report Thepatientwasunhappywithherdentalaesthet- ics after completion of fixed orthodontic treatment. In addition, she did not like the appearance of her incisal edges, nor the texture or translucency of the incisal third of her central incisors (Figs. 1 & 2). After gaining a clear understanding of the pa- tient’s expectations and having informed her of the therapeuticpossibilityoftreatingthecasewithcom- positeresin,itwasdecidedtomakeadiagnosticwax- up, elongating the height of the clinical crowns to correcttheirregularitiesoftheincisaledges.Wethen proceededtotakeapatternofthefuturerestorations with putty polyvinyl siloxane (PVS). This pattern was then tried in to gain a better idea of the quantity of composite needed to restore the teeth (Fig. 3). Following adequate cotton roll isolation, and af- ter gaining complete cooperation from the patient, the adhesive protocol for the enamel was followed andrestorationwithcompositeresinAMARIS(VOCO) was decided upon. The first increment of restorative material was placed in the PVS pattern and seated with gentle pressure on the palatal aspect of the pattern. AMARIS Translucent was placed in such a way that all the palatal surfaces of the restoration were completed on teeth #11, 21 and 22. In order to restorethecentralincisorssimultaneously,apartially thinned matrix (OptraMatrix, Ivoclar Vivadent) was lodged in the PVS pattern and each incisal edge was light-cured for 30 seconds (Figs. 4–6). The pattern that rapidly gave us all the anatomic features of the lingual aspect was then removed to continue stratifying the layers of this composite (AMARIS Opaque), seeking to insinuate the mamelons very slightly at the incisal third but close to the incisal edge itself, and at the same time spreading the composite onto the surface of the enamel, in order to hide the excessive translucent aspect that theseteethshowednaturally(Fig.6). In addition, we applied several brushstrokesofAMARISFlowHighOpaque(VOCO)in areaswhereitwasnecessarytohidethetranslucency, and at the same time it was useful for us to generate small areas of hypoplasia of enamel, resembling the natural characteristics of the lateral incisor. Finally, the whole surface of the incisal edge and the facial surface were covered with AMARIS Translucent again. Thereafter, the whole restoration was brushed up and light-cured for 60 seconds. Next,theocclusionwasadjustedandthecomposites finished (Figs. 7 & 8). The patient was very pleased with the final result andwasinformedofthenecessaryappointmentsfor follow-upsandmaintenance,occlusioncheck-ups,as wellasphotographicmonitoring.Theaccompanying photographs were taken three months post-oper- atively, the first one with dried teeth and the second in natural conditions during smile (Figs. 9 & 10)._ Editorial note: A complete list of references is available fromthepublisher. Fig. 10 Dr Rony Hidalgo Lostaunau Alameda del Crepúsculo 195 Alborada – Surco Lima 33 Perú hidalgo@endoroot.com cosmeticdentistry Fig. 9Fig. 8Fig. 7 _contact