Aesthetic restoration using composite resin in teeth with inactive carious lesions: a conservative and predictable approach

Patrícia Dias,Camila Ferreira Silva,Nafaira Rízzea Ferreira Silva,Paulo César De Freitas Santos-Filho,Victor Da Mota Martins,Uriel Paulo Coelho Silva

doi:10.1590/1981-863720200005220180101

Patrícia Dias, Camila Ferreira Silva + Show 4 more

Open Access

https://doi.org/10.1590/1981-863720200005220180101

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Abstract

ABSTRACT The importance of correct diagnosis, planning and treatment of dental spots is extremely important during aesthetic rehabilitation. Aesthetic requirements have become increasingly common in current society, and direct composite resin restorations are indicated due to the great advancement and increasing improvements of adhesive systems and composite resins. This work presents the clinical case of an oral aesthetic rehabilitation involving direct composite resin veneers associated with dental bleaching. The patient CSM, female, 21 years old, without systemic diseases, attended the dental clinic of the Morgana Potrich Eirelli College (FAMP) complaining of the unsatisfactory aesthetic appearance of her teeth. After careful anamnesis and detailed intraoral and extraoral examination, we identified the presence of a white spot on the upper anterior teeth. The spot was smooth and shiny, did not have soft tissue, and was well delimited and located in the cervical region. These characteristics led to the diagnosis of inactive carious lesions in the facial surface of the upper anterior teeth. After the treatment planning and its approval by the patient, the treatment started. The composite resin veneers associated with dental bleaching were indicated for better aesthetic results. The results achieved were satisfactory and met the patient’s aesthetic requirements by means of a correct diagnosis, study, and adequate planning for the case.

Highlights

Changes in tooth enamel are difficult to be diagnosed, because clinical characteristics are often very similar depending on the stage of the lesion
Among the different types of dental white spots, enamel hypoplasia, dental fluorosis, and amelogenesis imperfecta are directly related to disorders related to the development of active and inactive carious lesions [1]
The white spots were diagnosed as multiple inactive carious lesions

Summary

INTRODUCTION

Changes in tooth enamel are difficult to be diagnosed, because clinical characteristics are often very similar depending on the stage of the lesion. The dental bleaching followed the following steps: pumice and water prophylaxis with a Robinson brush and a rubber cup; Top Dam (FGM) gingival barrier application; desensitizing (Desensibilize KF 2% – FGM) application on the teeth that would be bleached and removal after ten minutes; following the manufacturer’s guidelines, hydrogen peroxide and thickener were mixed in the proportion 3:1 (Whiteness HP Max 35% – FGM) and applied in the whole tooth, but in the lingual surface, using a regular microbrush (KG); it was applied twice for ten minutes This procedure was repeated thrice with a 7-day interval (figure 2). Teeth were prepared for veneers using polishing diamond burs by means of a minimally invasive technique, i.e. a technique that causes little tooth wear This wear was carried out after the restorative test, where we observed that using resin to cover the white spots without wearing the teeth did not cover the spots properly. The polishing process of all teeth was performed using Jiffy Polisher cups (Ultradent), a cup-shaped Astrobrush polisher (Ivoclar) and felt discs (TDV) with an Enamelize paste (figure 6)

DISCUSSION

CONCLUSION