Anterior esthetic reestablishment with Vittra APS

Author: Dr. Orlando Reginatto.

25-year-old female patient.

CHIEF COMPLAINT:

Esthetics of the central upper incisive teeth.

INITIAL EVALUATION:

Tooth 11 presented a deep hypoplastic stain and tooth 21, fractured in childhood, showed an old restoration in composite with shade alteration. When evaluating the shade of the teeth, it was noticed that there was no need for whitening, since the patient was happy with the B1 saturation and hue.

TREATMENT:

We opted for the replacement of the restoration and for mimicking the white stain, besides changing the shape of the central incisive teeth, providing more volume and contour to their mesial walls.

STEP-BY-STEP:

Fig. 1a – Evaluation of the spontaneous smile.

Fig. 1b – Zoomed-in view of the incisive teeth.

Fig. 1c – Lips at rest.

Fig. 2 – Cavity preparation of the white stain of tooth 11 and making of the palatal index for the tooth 21 copying the old restoration.

Fig. 3 – Restorative test of tooth 11 showing that there is no need for more wearing. Vittra APS composite in shades DA0, DA1 and E-Bleach was used.

Fig. 4 – Preparation of tooth 21 and isolation.

Fig. 5 – Fitting of the silicon index.

Fig. 6 – Vittra APS in shade Trans OPL for the palatal shell.

Fig. 7 – Vittra APS in shade E-Bleach for the proximal walls.

Fig. 8a – Vittra APS in shade DA1 body composite covering the bevel of teeth 11 and 21.

Fig. 8b – Side view with the body composite finalized. Shade DA1 in the medium third and bevel. Shade DA0 only in the incisal part.

Fig. 9 – Final layer of Vittra APS in shade E-Bleach.

Fig. 10 – Final photograph of the smile.