Aesthetic rehabilitation of anterior crown fracture and multiple diastema : a case report

Abstract

Aim: An 18-year-old male patient applied our clinic with aesthetical needs. The presence of multiple and irregular diastema after orthodontic treatment and, a traumatic crown fracture on left central incisor (#21), were observed. This clinical case presents a treatment plan based on direct composite restorations in minimally invasive concept.Materials and methods: Firstly, a diagnostic impression was taken. Then a silicon index was obtained on the waxed-up cast. The teeth were isolated with rubber dam (Nictone, Velopex ,England). No preparation was made on the teeth surfaces except the fractured tooth. Enamel surfaces were conditioned with a phosphoric acid gel (Scotchbond Etchant, 3M ESPE, MN, USA). The adhesive (Scotchbond Universal Adhesive, 3M ESPE, MN, USA) was applied and then light cured for 10 seconds (Elipar DeepCure-S, 3M ESPE, MN, USA), in accordance with the manufacturer’s instructions. Palatal walls were formed using silicon index. On #21, multi-layered technique with opaque (OA2), body (A2) and enamel (CE) composites (Estelite Sigma Quite, Tokuyama Dental, Tokyo, Japan) was applied. On the other teeth, single shade body composite (A2) was used in layers. Each increment was light cured for 20s. 12-blade flame carbid burs (EVE, Germany), interdental tapes (Kerr, Italy), polishing discs and spirals (Sof-Lex, 3M, St. Paul, MN, USA) were used for finishing and polishing. Recalls were arranged after 1 week and 6 months.Result: At the follow-up observations, direct resin restorations were scored according to the modified USPHS (United States Public Health Service) Criteria, and all the scores were considered as ‘successful’.Discussion: In cases like crown fractures, diastema, malpositions and malformations direct composites constitute a well clinical choice to restore anterior teeth, preserving sound tooth tissue with respect to minimally invasive dentistry.