This athletic young boy had an accident on a soccer field about a week earlier and shattered the incisal edges of his central incisors. Other than some cold sensitivity, the teeth were asymptomatic.
The fractured pieces were lost and there was no pulpal exposures. There were some fracture lines passing through the remaining tooth structure with transillumination, but the remaining teeth were sound and radiographically displayed no root fractures.
We discussed the need for improvement of oral hygiene and anesthetized with 1.8 ml of 2% Lidocaine 1:100000 epinephrine. The surfaces were micro-abraded with 50 micron alumina oxide, etched with 37% phosphoric acid for 15 seconds, de-sensitized with Gluma (Bayer) and bonded with layer of Optibond Solo Plus (Kerr). After light curing for 20 seconds per tooth, the dentinal form was rebuilt with Venus AO2 (Hereaus) leaving the incisal edge irregular and light cured for 20 seconds. A second layer of Venus A1 was added and built slightly short of the final length and full facial contour. Composite tints were then used (Kerr Kolor Plus , white, lavendar and ochre) with a fine sable brush to create internal characters before a final layer of Durafill A1 (Heraeus).
The teeth were shaped with a fine tapered diamond bur and polished with an Enhance polishing cup (Caulk Densply), a blue and pink polishing cup (Cosmodent) and finally finished with a rotary brush (Kerr) in a slow speed.
The Durafill is most translucent and allowed the dentinal build-up and the composite tints to show through giving a life-like appearance. Placing a slightly irregular incisal edge mimiced the adjacent dentiton.
As the teeth rehydrated, the color match was very good and the surface texture and luster was very similar to the natural dentition.
The finished restorations recreated the natural form of the missing tooth structure and blended invisibly.
This athletic young boy had an accident on a soccer field about a week earlier and shattered the incisal edges of his central incisors. Other than some cold sensitivity, the teeth were asymptomatic.
The fractured pieces were lost and there was no pulpal exposures. There were some fracture lines passing through the remaining tooth structure with transillumination, but the remaining teeth were sound and radiographically displayed no root fractures.
We discussed the need for improvement of oral hygiene and anesthetized with 1.8 ml of 2% Lidocaine 1:100000 epinephrine. The surfaces were micro-abraded with 50 micron alumina oxide, etched with 37% phosphoric acid for 15 seconds, de-sensitized with Gluma (Bayer) and bonded with layer of Optibond Solo Plus (Kerr). After light curing for 20 seconds per tooth, the dentinal form was rebuilt with Venus AO2 (Hereaus) leaving the incisal edge irregular and light cured for 20 seconds. A second layer of Venus A1 was added and built slightly short of the final length and full facial contour. Composite tints were then used (Kerr Kolor Plus , white, lavendar and ochre) with a fine sable brush to create internal characters before a final layer of Durafill A1 (Heraeus). 
The teeth were shaped with a fine tapered diamond bur and polished with an Enhance polishing cup (Caulk Densply), a blue and pink polishing cup (Cosmodent) and finally finished with a rotary brush (Kerr) in a slow speed.
As the teeth rehydrated, the color match was very good and the surface texture and luster was very similar to the natural dentition.
The finished restorations recreated the natural form of the missing tooth structure and blended invisibly.
2 comments:
Hello Dr. Spoor. I read your excellent articles in AP Dental News. Nice blog!
Brilliant results!
Post a Comment