Cosmetic Tribune U.K. Edition

April 201414 United Kingdom Edition page 13DTß ‘The case pre- sented describes a minimally invasive way of addressing this problem using direct composite bonding’ cured (Fig 6). The next step entailed cre- ating palatal and two lateral enamel walls that were com- pleted using increments of enamel-shade resin. Creating a lingual shelf in this manner left room for the subsequent dentine layering (Fig 7). The appropriate dentine- shade resin was then applied in order to create distal and mesial lobes. These were light cured for ten seconds (Fig 8). Dentine in a darker shade was placed onto the cervical third. Prior to light curing, the white strip was painted horizontally along the incisal edge of the enamel shelf using a white tint and smooth brush (Fig 9). Finally, an enamel resin layer was placed, contoured, smoothed with a brush and light cured (Fig 10). After completion of com- posite applications and poly- merisation, fine flame-tipped finishing diamond burs and Sof-Lex discs (3M ESPE) were used for gross contouring and creating texture. The final pol- ish was achieved using rub- ber finishers, a brush, a felt wheel and a paste kit (Fig 11). The same procedures were followed during reconstruction of the left lateral incisor (Figs 12&13). Figures 14 to 16 show the situation 30 days post-op- eratively. The lateral incisors show favourable integration of form and colour as achieved through the direct composite resin restoration procedure. Adequate contours and propor- tions create a smile with har- monious symmetry and a natu- ral appearance. Some cases present with conoid lateral incisors dis- playing a lack of gingival harmony, as were the cas- es with those patients (Figs 17&20). This usually manifests as the translocation of the gin- gival contour coronal to the zenith of the canine and the central incisor. Such a clinical situation requires gingival re- contouring before direct resto- ration. In presented cases, the re- contouring procedure was carried out using a Soft Tis- sue Trimmer bur (Edenta). Modifications were limited by the patient’s biologic width. As observed at four- week follow-up visits, there was a very good gingival re- sponse to the polished restora- tions (Figs 19&21). Conclusion Conoid lateral incisors are not uncommon. They may be found unilaterally or bilater- ally. Their poor appearance can spoil an otherwise attrac- tive smile. The case presented describes a minimally invasive way of addressing this problem using direct composite bond- ing. The step-by-step images il- lustrate how dentists can solve this cosmetic issue without us- ing aggressive techniques and with the advantage of being in full control of shade matching and characteri- sation. DT About the author Dr Monika Marcin- iak graduated from the Medical Univer- sity of Białystok in Poland in 1992, and runs a private prac- tice with her hus- band. She has been publishing articles on direct compos- ite restorations since 2007. She is a member of the European Society of Cosmetic Dentistry. Contact her at dentystamarciniak@dentonet.pl Cosmetic Tribune Fig 5 Fig 6 Fig 7 Fig 8 Fig 9 Fig 10 Fig 11 Fig 12 Fig 13 Fig 14 Fig 15 Fig 16 Fig 17 Fig 18 Fig 19 Fig 21Fig 20 10%OFF 10%OFF 10%OFF A L L H A N D P I E C E REPAIRS Q U OTEMAG 1 4 Don’t let your handpieces fail.... SERVICE REGULARLY WITH Components that make a difference to the performance of your equipment Advice on maintenance for your handpieces No hidden costs Lower handpiece lifetime costs REPAIR SERVICE THAT GUARANTEES: CALL NOW 01253 404774 FOR YOUR FREEPOST REPAIR PACK CALL NOW 01253404774

Cosmetic Tribune U.K. Edition

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