How to get a perfect reattachemnt result using only one body mass and no enamel to reach the great esthetic outcome and a perfect camaleontic morphology.

The developments of materials and methods in adhesive dentistry lead more aesthetic, functional and
minimally invasive direct resin restorations. Single visit treatment option is one of the main advantages of
these natural alike restorations when considering the treatment plan. Polychromatic or monochromatic, minimally invasive composite veneer restorations covering whole labial/buccal surface of anterior teeth, are also good treatment options compared to the rival ceramic veneer restorations. Direct composite veneers were told to have some disadvantages as instability and discoloration in the past years. However with correct indication, good isolation, successful adhesion, proper technique, detailed polishing procedures and frequent recalls, these restorations may have long-term clinical success. Formerly called ‘temporary fillings’ are called ‘direct aesthetic restorations’ now as they deserve.

Aesthetic restorations are challenging in many ways as both function and aesthetic are of primary importance.
This young patient presented in the University Department with a class IV fracture after a sport accident, and he requested to have an immediate restoration.
In order to build a silicon key, a pre-restoration (using no Dentin Bonding Agent) was placed. An additional silicon key was created to check the thickness during the layering, so that a correct amount of dentin and enamel could be layered.
This would facilitate the correct integration with natural dentition from the chromatic point of view.
Careful attention was given to the adhesive protocol steps, and to the correct layering of enamel and body masses.
Here is the clinical case Gallery, with the step by step procedure.

The patient came to our office with a large diastema between 31 and 41. It was decided to solve this by distributing orthodontically the space between the four incisors and later carry out composite reconstructions. In this way we avoided to create two large central teeth which would have been aesthetically unpleasant.

I had the chance to be among the first to test the new concept proposed by Tokuyama with the Omnichroma composite “One choice for every shade”. I wanted to test it in the rehabilitation of the posterior sectors and check it after a month even under the radiographic aspect. The clinical phases highlight the isolation with
a rubber dam, the cavitary preparation, the adhesive phases and the subsequent use of Omnichroma to restore the correct morphology. Finally radiographic control, finishing and check. Even after 1 month to verify the success of the restoration not only from an aesthetic point of view

I was the first dentist in Turkey to have the chance to test this new composite from Tokuyama, Asteria. I was very surprised discovering interesting features of it. My first impressions are that it easy to use in layering, it has a simple understandable shade tabs and it is easy to work. In the other hand this material has a very good color match and super shine, and this is important in our dental practice to obtain a very good esthetic final result.

In metal-ceramic crowns on implants, the hole to access the healing screw can be an esthetic problem for the patient, both for the composite camouflage to be used and for the opacification of the underlying metal structure.
Teflon is placed to protect the screw head and therefore leaving the metal surface covered. The ideal condition is leaving approx. 2 mm of margin in pure ceramics exposed on the metal structure to achieve a good adhesion and at the same time a camouflage of the composite and of the ceramic.
the exposed ceramic surface is etched with fluoridric acid (HF 9.6%) for 60 seconds to obtain the area’s microroughness. After etching the area, it is cleaned and dried, and then Tokuyama Universal Bond is applied, following the manufacturer’s prescriptions.
The layering is carried out with a first thin layer of Omnichroma Blocker, as if it were a dentin mass, and then supercolors Tokuyama Estelite Color (Dark Brown) are applied to characterize cavities and fissures. The restoration is completed using Omnichroma (used as an enamel mass), to achieve an optimal final result.