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cosmetic dentistry_ beauty & science

for15secondswithTotalEtch.Thisetchinggelcon- tains37%phosphoricacid.Thesurfaceswererinsed for 20 seconds and then carefully dried according to the wet-bonding principle (adhesion to moist surfaces). As a result, the enamel was dry, while the dentineremainedsomewhatmoist.Thisdryingstep requires utmost care when this type of adhesive is used. If the moisture content within the dentine tubules is too high or if the collagen fibres collapse owing to excessive drying, the penetration of the adhesive, and therefore the bond strength, will be reduced. The single-component adhesive ExciTE (Ivoclar Vivadent) was applied to the enamel and dentine and allowed to react for ten seconds. An indirect stream of air was used to evaporate the solvent contained in the adhesive. In the process, the air spray was applied to a mirror in the mouth, which was held at an angle to the prepared tooth surface. As soon as the surface was lustrous, the adhesive was further polymerised for ten seconds (low power mode of the bluephase G2 LED curing light, Ivoclar Vivadent). _Layering of the composite resin First, the composite resin was applied to the palatalareas.TheenamelmaterialA1wasappliedin the silicone matrix. In order to avoid the formation ofbubbles,thecompositeresinwasdistributedvery carefully. The matrix was placed in the patient’s mouth and positioned on the palatal surface with lightpressure.Thecompositeresinwaspolymerised for 15 seconds using the soft start mode (Fig. 5). Small lobes of dentine material (A2) were sub- sequently applied. The position of these lobes was individually determined. The aesthetic results were based on the contralateral teeth, which served as a comparison. In this case, the mamelons were clearlyseparated.Theyendedbelowtheincisaledge (Fig. 6). By observing the existing anatomical fea- tures,anatural-lookingandaestheticoutcomewas achieved. The composite resin was applied in small amounts, which were periodically cured with the bluephase curing light in the soft start mode. The dentine material was then applied and light-cured. Next, the incisal edge of the tooth, that is, the outermost part of the restoration, was recon- structed. Small amounts of the translucent incisal materialTwereplacedbetweenthedentinemamel- ons. A probe came in useful in these narrow areas. Finally, the entire labial surface was coated with Tetric EvoCeram Bleach 1, ensuring that both the dentine lobes and the incisal edge were completely covered. The Bleach shade made the tooth appear lighter. The dentine material imparted the composite re- sin restoration with a tooth- like appearance. The Bleach shade was responsible for the tooth’s natural-looking brightness. _Surface finishing The aesthetic outcome is largelybasedonthesuccess- ful recreation of the surface texture. The imitation of the shape and surface details is just as important as that of the fine colour nuances. In the treatment of a child’s tooth in particular, it is im- portant to take the micro- and macro-anatomical struc- ture into consideration. The surface was finished with finishing diamonds (first red, then yellow). Spray was not used. Work was done using a surgical microscope. The restoration was finally polished with the Astropol system (using water spray; IvoclarVivadent).Incontrast to polishing discs, these rub- ber tips do not harm the sur- face structure. _Conclusion The fabrication of natu- ral-looking, highly aesthetic restorations is a re- warding task with Tetric EvoCeram materials and the increment technique. The Bleach shade on the tooth surface brightens the restoration. This ap- proach is extremely helpful in the restoration of children’steeth.Withthehelpofthisadhesivetech- nique, teeth can be restored in a minimally invasive manner (Figs. 7 & 8)._ Fig. 5_Build-up of the palatal surface with enamel material (A1). The precision of the morphology is already impressive at this stage. Fig. 6_Lobes are created with dentine material (A2). The translucent material is placed between these mamelons. Fig. 7_A comparison: before ... Fig. 8_... and after: the Bleach shade on the surface of the restoration imparts the tooth with the necessary brightness. I 37 industry report _ Tetric EvoCeram I cosmeticdentistry 4_2011 Fig. 6 Fig. 7 Fig. 5 Fig. 8 Dr David Hacmoun 33 bvAlbert 1er 06600Antibes France cosmeticdentistry _contact