A Simplified Approach to Esthetic Layering of Composite Resins in the Anterior Zone

Kevin Brown, DDS

Patients often present with a chipped or broken anterior tooth/teeth and want it fixed immediately and expect the esthetic outcome to be excellent. Using a traditional polychromatic composite layering technique can be highly effective in providing esthetic restorations for such cases. However, clinicians may not always have a broad spectrum of composite shades in stock for such situations, making the procedure challenging. The technique described in this case presentation follows the same principles and approach that are involved in polychromatic layering, but uses a single-shade composite system. The patient had a dark tooth shade of A4+. Fractured teeth Nos. 8 and 9 were minimally prepared with a 45-degree infinity bevel and air abrasion. A silicone putty index was fabricated and used to establish a palatal shell, which would act as a framework upon which subsequent layers would be added. Using OMNICHROMA one-shade universal composite (Tokuyama Dental, tokuyama-us.com) and OMNICHROMA BLOCKER along with a few colored resins, the clinician was able to achieve excellent shade-matching and esthetic results, rivaling even the best polychromatic layering approach. These teeth were quite dark, but the single-shade composite system enabled optimal results, and is capable of attaining similar outcomes on teeth ranging from shade B1+ to all other shades.

OMNICHROMA single-shade composite system can be used with a layered approach in the anterior segment to achieve similar esthetic results to polychromatic layering while simplifying technique and material inventory.

Use of a single-shade composite system on anterior restorations allows for color matching over a broad range of shades. Additionally, as the patient's tooth shade changes over time, the restoration will continue to match.

Tooth preparation is key to achieving a seamless margin. When restoring incisal length greater than 1 mm on an anterior tooth with single-shade composite, the supplemental OMNICHROMA BLOCKER is indicated to help mask the hard incisal edge of the natural tooth.

Kevin Brown, DDS
Accreditation, American Academy of Cosmetic Dentistry; Private Practice, Bellevue, Washington

Figures and Images

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Figure 1

Fig 1. Pretreatment full smile.

Figure 2

Fig 2. Pretreatment close-up view of fractured teeth Nos. 8 and 9.

Figure 3

Fig 3. Right lateral close-up view of tooth preparation of teeth Nos. 8 and 9 showing the 45-degree infinity bevel and air abrasion that will allow for a seamless margin.

Figure 4

Fig 4. A silicone putty index was used to guide the formation of a palatal shelf, using OMNICHROMA Flow and a sable brush.

Figure 5

Fig 5. After the silicone putty index was removed, a fine-grit polishing disc (Sof-Lex™, 3M Oral Care) was used to refine and perfect the incisal edges prior to subsequent layering.

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Fig 6. OMNICHROMA BLOCKER was used to replicate a dentin layer to help block out the hard incisal edge of the natural tooth.

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Fig 7. A thin layer of OMNICHROMA was placed to just shy of the final facial contour.

Figure 8

Fig 8. Colored liquid resins were used to help replicate the natural internal effects of the existing dentition with ochre, opaque chroma, and white. Using the fine tip of a sable brush, the colored resins were applied to replicate the vertical craze lines and chromatic effects.

Figure 9

Fig 9. The final layer of OMNICHROMA was layered to the final facial contours.

Figure 10

Fig 10. Immediate post-treatment after texturizing and polishing.

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Fig 11. Immediate post-treatment right lateral view showing how the composite blended seamlessly into the existing enamel.

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Fig 12. Immediate post-treatment full smile.