Esthetic rehabilitation of anterior teeth through gingival recontouring and ceramic veneers: a case report

Esthetic rehabilitations require a broad and thorough evaluation of all the elements that make up the smile such as lips, dental, and periodontal structures to plan the treatment to provide harmony to the whole set. Objective: To demonstrate through a case the association of Periodontics and Restorative Dentistry in the esthetic rehabilitation of anterior teeth replacing resin restorations by modifying the gingival architecture conservatively and harmonically. Case report: It is essential for a multidisciplinary approach to succeed in treatment. The replacement of previous restorations is an increasing demand in currently clinical practice, for many reasons, mainly due to dissatisfaction with the esthetics. It is observed that many of these patients involve not only dissatisfaction with the dental structure but also with the periodontal health, for this reason, it is necessary a previous adaptation of the gingival tissues for proper restorative rehabilitation. Conclusion: Ceramic laminates have proved to be a great choice for anterior teeth restorations, but they must be indicated in specific situations, to obtain excellent results as most conservative as possible.Esthetic rehabilitations require a broad and thorough evaluation of all the elements that make up the smile such as lips, dental, and periodontal structures to plan the treatment to provide harmony to the whole set. Objective: To demonstrate through a case the association of Periodontics and Restorative Dentistry in the esthetic rehabilitation of anterior teeth replacing resin restorations by modifying the gingival architecture conservatively and harmonically. Case report: It is essential for a multidisciplinary approach to succeed in treatment. The replacement of previous restorations is an increasing demand in currently clinical practice, for many reasons, mainly due to dissatisfaction with the esthetics. It is observed that many of these patients involve not only dissatisfaction with the dental structure but also with the periodontal health, for this reason, it is necessary a previous adaptation of the gingival tissues for proper restorative rehabilitation. Conclusion: Ceramic laminates have proved to be a great choice for anterior teeth restorations, but they must be indicated in specific situations, to obtain excellent results as most conservative as possible

Efeito de diferentes meios de imersão na emissão fluorescente de resinas compostas

O objetivo deste trabalho foi avaliar o efeito do manchamento sobre a intensidade de fluorescência de resinas compostas, em função dos meios de imersão e do tempo. Para isso, foram selecionadas as seguintes resinas compostas: Filtek Supreme XT (3MESPE), 4 Seasons (Ivoclar Vivadent), Venus (Heraeus – Kulzer), Vit~l~escence (Ultradent) e Esthet-X (Dentsply). Foram selecionadas também as seguintes soluções: café, suco de laranja, refrigerante de cola, vinho tinto e saliva (controle). Para cada condição experimental foram confeccionados cinco corpos-deprova (n=5) em forma de disco medindo 10,0mm de diâmetro e 1,0mm de espessura, que permaneceram imersos em saliva artificial e mantidos em estufa a uma temperatura de 37ºC±1. Esses corpos-de-prova foram retirados da estufa três vezes ao dia para imersão nas soluções testadas, durante o período de cinco minutos. Após este período foram lavados em água corrente e novamente imersos em saliva artificial e mantidos em estufa, até o momento da mensuração da intensidade de fluorescência. As leituras foram realizadas em seis níveis de variação: T0 - após confecção dos corpos-de-prova sem imersão em saliva artificial; T1 - 24 horas após imersão em saliva artificial; T2 - 24 horas após imersão nas soluções; T3 - 07 dias após imersão nas soluções; T4 - 14 dias após imersão nas soluções e T5 - 21 dias após imersão nas soluções. Para a obtenção dos valores de intensidade de fluorescência foi utilizado um espectrofotômetro (Spex Triax Fluorolog 3) calibrado para que o raio incidente fosse emitido com um comprimento de onda de 390nm e para que todo o fenômeno de fluorescência fosse registrado em uma faixa compreendida entre 400nm e 700nm. Os resultados obtidos foram submetidos à Análise de Variância e ao Teste de Tukey a 5%. De acordo com os resultados observou-se que as soluções influenciaram...The aim of this study was to evaluate the effect of staining on the fluorescence intensity of composite resins, depending on the solutions and immersion time. The following composites were selected: Filtek Supreme XT (3MESPE), 4 Seasons (Ivoclar Vivadent), Vênus (Heraeus – Kulzer), Vit~l~escence (Ultradent) and Esthet-X (Dentsply). We also selected the following solutions: coffee, orange juice, cola soft drink, red wine and artificial saliva (control). For each experimental condition were made five specimens (n=5) in a disk shape measuring 10,0mm diameter and 1,0mm thickness. All the specimens were immersed in artificial saliva and kept in an incubator at a temperature of 37ºC±1. The specimens were removed from the incubator three times a day for immersion in the solutions tested, during the period of five minutes. After it was washed in running water and again immersed in artificial saliva, until the time of measurement of fluorescence intensity. The readings were taken at six levels of variation. T0 - 24 hours after preparing the specimens, T1 - 24 hours after immersion in artificial saliva, T2 - 24 hours after immersion in the solutions, T3 after seven days, T4 after fourteen days and T5 after 21 days. To obtain the values of fluorescence intensity, was used a calibrated spectrophotometer (Spex Triax Fluorolog 3) with an incident ray delivered with a wavelength of 390nm. The phenomenon of fluorescence was registered between 400nm and 700nm. The results were submitted to the analysis of variance and Tukey's test 5%. The results showed that the solutions influenced the intensity of fluorescence emitted by resin composites (p<0,05). Coffee was the higher staining solution, followed by red wine, orange juice, cola soft drink and artificial saliva. Regarding the time it was noted that after T2 there was a significant change in fluorescence emission... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Cosmetic Remodeling of the Smile: Combining Composite Resin and Ceramics over Teeth and Implants

The aim of this paper is to describe a restorative approach to the cosmetic remodeling of the teeth of a young adult patient with right maxillary lateral hypodontia and left lateral microdontia. A conservative restorative management was proposed to improve smile esthetics by combining direct composite resins and ceramics. Initially, periodontal therapy and dental bleaching were performed. Subsequently, direct composite resins were applied to the central incisors and canines to reestablish the sizes and shapes of these teeth. Finally, ceramics were placed on the implant and the microdontia to unite with the new alignment and color of the anterior teeth. Thus, conservative remodeling to improve the harmony of the smile was provided

Efeito de fontes de luz na microdureza de resinas compostas

This study assessed the surface microhardness of compound resins cured by different light sources. Methods Three micro hybrid (Vit-l-escence, Amelogen Plus, Opallis) and one nanoparticle (Filtek Z350, 3M ESPETM Dental Products, St. Paul, USA) compound resins were selected. The resins were polymerized by a halogen light unit (Ultralux, Dabi Atlante, Ribeirão Preto, Brasil) with two tips, one semi-guided made of glass and another of painted acrylic and a LED-based source (UltraLume 2, Ultradent®, South Jordan, USA). Specimens constructed from a circular aluminum matrix were photopolymerized for 40 second after they received the compound resin and stored dry for 24 hours. After this period, a Vickers surface microhardness assay was performed, measuring the top (hardness 1) and base (hardness 2) surfaces four times each. Variance analyses were complemented by Newman-Keuls method, with significance set at 5%. Results The Opallis (FGM, Santa Catarina, Brasil) resin subjected to UltraLume 2 (Ultradent®, South Jordan, USA) obtained the lowest mean hardness values for the top surface. The Vit-l-escence (Ultradent®, South Jordan, USA) compound cured by Led UltraLume 2 (Ultradent®, South Jordan, USA) and by Ultralux PCP (Dabi Atlante, Ribeirão Preto, Brasil) halogen light obtained the highest mean hardness, followed by the Filtek Z350 (3M ESPETM Dental Products, St. Paul, USA) resin subjected to UltraLume 2 (Ultradent® South Jordan, USA). The Opallis (FGM, Santa Catarina, Brasil) resin cured by LED UltraLume 2 (Ultradent®, South Jordan, USA) also obtained the lowest mean hardness for the base surface and the Vit-L-Escence (Ultradent®, South Jordan, USA) resin obtained the highest value, followed by Amelogen Plus, when cured by Ultralux (Dabi Atlante, Ribeirão Preto, Brasil) using the semi-guided tip. Conclusion The polymerization and, consequently, the microhardness achieved by the LED unit was equivalent to those achieved by conventional halogen units for three of the four composites tested.Avaliar a microdureza superficial de resinas compostas polimerizadas por diferentes fontes de luz. Métodos Foram selecionadas três resinas compostas microhíbridas (Vit-l-escence, Amelogen Plus, Opallis) e uma nanoparticulada (Filtek Z350, 3M ESPETM Dental Products, St. Paul, USA). Foram submetidas à polimerização utilizando-se um aparelho halógeno (Ultralux, Dabi Atlante, Ribeirão Preto, Brasil) com duas ponteiras, uma de vidro semi-orientada e outra de acrílico pintada e também um dispositivo à base de LED (UltraLume 2, Ultradent®, South Jordan, USA). Os corpos-de-prova obtidos a partir de uma matriz circular de alumínio, após receberem a resina composta, foram fotopolimerizados por 40 segundos e em seguida armazenados a seco por 24 horas. Decorrido esse período, procedeu-se ao ensaio de microdureza superficial Vickers, realizando-se quatro aferições na superfície de topo (dureza 1) e na superfície de base (dureza 2). Utilizou-se a análise de variância que foi complementada pelo teste de Newman-Keuls de comparações múltiplas de médias, ao nível de significância de 5%. Resultados No topo, as menores médias de dureza foram obtidas com a resina Opallis submetida ao UltraLume 2 (Ultradent®, South Jordan, USA). As médias maiores referem-se ao compósito Vit-l-escence (Ultradent®, South Jordan, USA) polimerizado com o Led UltraLume 2 (Ultradent®, South Jordan, USA) e luz halógena Ultralux PCP (Dabi Atlante, Ribeirão Preto, Brasil), seguidas da resina Filtek Z350 (3M ESPETM Dental Products, St. Paul, USA) submetida ao UltraLume 2 (Ultradent®, South Jordan, USA). Quanto à base, a menor média de dureza também foi da resina composta Opallis (FGM, Santa Catarina, Brasil), sob ação do LED UltraLume 2 (Ultradent®, South Jordan, USA) e a maior da Vit-l-escence (Ultradent®, South Jordan, USA), seguida pela Amelogen Plus (Ultradent®, South Jordan, USA) quando polimerizada pelo Ultralux (Dabi Atlante, Ribeirão Preto, Brasil) com a ponta semi-orientada. Conclusão O aparelho LED permitiu polimerização e consequentes valores de microdureza equivalentes ao dos aparelhos halógenos convencionais, para três dos quatro compósitos avaliados

Esthetic Rehabilitation with Direct Composite Resin in a Patient with Amelogenesis Imperfecta: A 2-Year Follow-Up

Amelogenesis imperfecta is a group of conditions caused by over 15 different genes that affects the development of dental enamel and poses some challenges to dentists. An adult patient with amelogenesis imperfecta with severe changes in tooth color and reduction of occlusal vertical dimension sought dental treatment. Diagnostic wax-up was carried out to guide the stratification of a nanoparticulate resin for the restorative treatment. Direct composite resin restorations were applied on all teeth for modification of both esthetics and occlusion. After a 2-year follow-up, the findings appear to suggest that composite resin is a low-cost alternative when compared with indirect ceramic restorations, provides a good esthetic outcome, and offers considerable longevity for cases like the one reported herein

Clinical Steps for Restoration of Fractured Anterior Teeth: Color Protocol with Non-VITA Scale

Direct composite resin restorations are commonly provided because of their satisfactory esthetics and minimal wear of opposing tooth structure. Recent restorative systems may not follow the nomenclature of the classical VITA shade guide, using instead a simplified resin color system. A better understanding of these systems and their behavior regarding the incidence of light is an excellent approach to anterior restorations, especially for fractured anterior teeth. This paper demonstrates the color selection and clinical sequence for the natural reproduction of tooth structure using a resin system that does not follow the VITA classical scale