This was an interesting minimally invasive resin bonding case to improve esthetics of 8 and 9 for this 16 year old female. It is clear that she had a history of childhood dental trauma as evidenced by a subgingival hypoplastic effect in accordance with Turner’s tooth/hypoplasia. The gingival esthetics were modified with a diode gingivectomy on SuperPulsed mode (Gemini, Ultradent, setting 1.1W) before a closed flap osteotomy was completed using a Kois Wedelstaedt chisel to re-establish biologic width. The line angle of #9MB was found to be deficient along with the volume of the MI aspect of the incisal embrasure. Subgingivally, there was a smooth anatomic defect penetrating both pulpally in direction as well as along a narrow tract apically along the root surface. Adhesive dentistry was completed in these regions featuring microlayering to minimize both shrinkage stress and polymerization shrinkage stress on the hybridized dentin. Tooth 8 was cut back to remove the undesirable chromaticity and micro air abraded using a 27 micron aluminum oxide powder before a total etch technique, 2% CHX (aq) dwell, bond (Optibond Solo Plus, Kerr) and the restoration layered using a combination of XL1 Enamel, XL2 Dentin, Trans Clear (Harmonize, Kerr) and tinted (halo effect, incisal maverick dentin connections to halo effect) with Kerr Kolor White.
All in all, a very satisfying case, albeit never perfect, but sometimes, it is those subtle imperfections that result in a more natural look. But we will always strive for perfection nonetheless.
Have a great weekend.
#Kerr #Harmonize #KerrKolor #compositelayering #cosmeticdentistry #TamDentalGroup #SkulptingSkool