Replacement of composite in anterior tooth with Vittra APS Unique composite

Authors: Ms. Jonathan G. B. Tenuti and Ms. Rodrigo Dacoreggio.

24-year-old female patient.

CHIEF COMPLAINT:

Dissatisfied with margins and shine of the restoration.

INITIAL EVALUATION:

Harmonized smile after the orthodontic treatment, showing giroversion of the element 12. The patient had a poorly contoured and color-altered restoration on the element.

TREATMENT:

The treatment initially proposed to the patient was polishing and adequation of the margins of the restoration on element 12. However, when evaluating the contact area with the help of dental fl oss, a failure in the old restorative process was noted, which required the replacement of the restoration (fig. 1). The careful removal of the poorly contoured composite with multiblade burs and a scalpel blade (fig. 2) started immediately.

After the complete removal, the professional noticed a mesial rotation of the element 12 and a diastema in the incisive-mesial region (fig. 3). For the replacement of the composite, a layer of universal chroma composite Vittra APS Unique was applied for shade testing (fig. 4).

That composite is recommended for anterior teeth due to its technology which absorbs and reflects the hue of the remaining tooth (fig 5), making it ideal for strategic additions in esthetic areas or even on posterior teeth in several classifications. For the restoration of the element in question, all the procedures recommended by the manufacturer were carried out. Once the isolation of the operation site was finished, the enamel was acid etched for 30 seconds.

After washing and drying, the Ambar APS adhesive was used because it is colorless, bringing even more naturality to the case (fig. 6). The ergonomic syringe of Vittra APS Unique makes it easier to remove the composite without contaminating its interior with possible particles (fig. 7).

One single increment of the universal chroma composite was taken to the vestibular face of the tooth and accommodated with the help of spatulas and brushes, together with a polyester matrix under traction for the creation of a new contact site and closing of the incisal diastema (figs. 8 and 9).

For the finalization, multiblade burs and Diamond Pro sandpaper disks were used for the finishing of the vestibular face and margin (fig. 10). For polishing, the polishing paste Diamond Excel was used with Diamond Flex disks, since the material provides easy shine obtainment and maintenance (fig. 11).

After finalizing the case, the patient has been satisfied with the results since the margins of the restoration are not apparent and there is excellent shine and light reflection. The composite proved to be reliable and efficient becoming part of the dental element without identifying the restorative process (fig. 12).