Single visit biomimetic restoration with multilayered direct composite technique on maxillary central incisor
Downloads
Background: Biomimetic restoration with multilayered composite gives the highest aesthetic result with the least invasive tooth structure. The goal of these techniques is to restore teeth while closely mimicking the micro- and macrostructure, chromatic properties, and tooth symmetry of the original dentition. These techniques need extra instruments and the clinician's experience. Purpose: This case study aims to describe a technique for repairing anterior defects in just one appointment. Case: A 24-year-old man complained about the color, asymmetry, and fracture of his anterior teeth. However, he does not have much time to wait for the indirect restoration procedure. A single-visit treatment was preferred for this case. Case Management: A manual wax-up for the palatal index followed by multilayered composite restoration was nicely done in a single appointment. Defects in anterior teeth could be repaired in a single appointment using multilayer direct composite restoration. This method could effectively replicate the teeth's morphology, symmetry, micro-macro structure, and chromatic properties. The quick manual wax-up and layering steps are critical to this procedure. Discussion: Currently, direct restorations for anterior teeth are completed in three stages: incisal edge and palatal wall shaping; interproximal wall creation utilizing a pre-contoured matrix technology; and buccal surface application of multilayered composite. Multilayered direct composite restoration technique with manual palatal index can be an alternative procedure to create immediate natural-looking anterior restoration. This technique offered a reduction of chairside time in a single-stage appointment, laboratory cost savings, and more predictable results.
Xia J, Li Y, Cai D, Shi X, Zhao S, Jiang Q, Yang X. Direct resin composite restoration of maxillary central incisors using a 3D-printed template: two clinical cases. BMC Oral Health. 2018;18(1):1-8. DOI:10.1186/s12903-018-0621-4
Lempel E, Lovász BV, Meszarics R, Jeges S, Tóth Á, Szalma J. Direct resin composite restorations for fractured maxillary teeth and diastema closure: A 7 years retrospective evaluation of survival and influencing factors. Dent Mater. 2017; 33(4): 467-476. DOI:10.1016/j.dental.2017.02.001
Opdam NJ, Van De Sande FH, Bronkhorst E, Cenci MS, Bottenberg P, Pallesen U, Gaengler P, Lindberg A, Huysmans MC, Van Dijken JW. Longevity of posterior composite restorations: a systematic review and meta-analysis. J Dent Res. 2014; 93(10): 943-949. DOI:10.1177/0022034514544217
Paolone G, Scolavino S, Gherlone E, Spagnuolo G, Cantatore G. The “pre-finishing” approach in direct anterior restorations. A case series. Dent J (Basel). 2021; 9(7): 79. DOI:10.3390/dj9070079
Cho K, Rajan G, Farrar P, Prentice L, Prusty BG. Dental resin composites: A review on materials to product realizations. Composites Part B: Eng. 2022; 230: 109495. DOI:10.1016/j.compositesb.2021.109495
Elfakhri F, Alkahtani R, Li C, Khaliq J. Influence of filler characteristics on the performance of dental composites: A comprehensive review. Ceram Int. 2022; 48(19): 27280-27294. DOI:10.1016/j.ceramint.2022.06.314
Dias Furtado M, Immich F, Luiz De Oliveira Da Rosa W, Piva E, Fernandes Da Silva A. Repair of aged restorations made in direct resin composite – A systematic review. Int J Adhes. 2023; 124: 103367. DOI:10.17605/OSF.IO/WZTGS
de Kuijper MC, Cune MS, Özcan M, Gresnigt MM. Clinical performance of direct composite resin versus indirect restorations on endodontically treated posterior teeth: A systematic review and meta-analysis. J Prost Dent. 2023; 130(3): 295-306. DOI:10.1016/j.prosdent.2021.11.009
Mazzetti T, Collares K, Rodolfo B, da Rosa Rodolpho PA, van de Sande FH, Cenci MS. 10-year practice-based evaluation of ceramic and direct composite veneers. Dent Mater. 2022; 38(5): 898-906.
Ammannato R, Ferraris F, Allegri M. The “index cutback technique”: a three-dimensional guided layering approach in direct class IV composite restorations. Int J Esthet Dent. 2017; 12(4): 450-66.
Gao Y, Li J, Dong B, Zhang M. Direct composite resin restoration of a class IV fracture by using 3D printing technology: A clinical report. J Prost Dent. 2021; 125(4): 555-9.
Paolone G, Scolavino S, Gherlone E, Spagnuolo G. Direct esthetic composite restorations in anterior teeth: Managing symmetry strategies. Symmetry (Basel). 2021; 13(5): 797. DOI:10.3390/sym13050797
Liu J, Zhang J, Liu W, Liang S. Combining a CAD-CAM composite resin palatal wall with a direct composite resin layering technique for the restoration of a large Class IV fracture: A clinical report. J Prost Dent. Published online 2024. DOI:10.1016/j.prosdent.2024.02.033
D’Arcangelo C, Buonvivere M, De Angelis F. Anterior Esthetic Restorations with the Stratified Stamp Technique: A Case Report. Biomimetics. 2024; 9(5): 299. DOI:10.3390/biomimetics9050299
Rao AS, Bhor S, Chhabra N. Comparative evaluation of aesthetic outcome of direct polychromatic composite layering and the “index cut-back technique” for restoring class IV defects using a newly patented simulated 3D printed mould: An in vitro study. J Oral Biol Craniofac Res. 2022;12(5):552-556. DOI:10.1016/j.jobcr.2022.07.007
Elzayat GA, Elsayed MM, Zoghby AFE. Clinical performance of direct anterior composite restorations using esthetic dual-shade versus polychromatic natural layering technique: A split mouth randomized controlled clinical trial. Braz Dent Sci. 2020; 23(4): 1-12. DOI:10.14295/bds.2020.v23i4.2064
Geštakovski D. The injectable composite resin technique: biocopy of a natural tooth-advantages of digital planning. Int J Esthet Dent. 2021; 16(3): 280-99.
Chandrapal A. Restoration of anterior teeth using polychromatic layering techniques. Dent Update. 2019; 46(4): 353-60.
Paolone G. Direct composite restorations in anterior teeth. Managing symmetry in central incisors. Int J Esthet Dent. 2014; 9(1): 12-25.

This work is licensed under a Creative Commons Attribution 4.0 International License.

CDJ by Unair is licensed under a Creative Commons Attribution 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions