Litcius/Paper detail

Post‐orthodontic recontouring of anterior teeth using composite injection technique with a digital workflow

Keiichi Hosaka, Antonín Tichý, Yasuji Motoyama, Koji Mizutani, Wei‐Jen Lai, Zuisei Kanno, Junji Tagami, Masatoshi Nakajima

2020Journal of Esthetic and Restorative Dentistry36 citationsDOI

Abstract

OBJECTIVE: Restorative treatment of anterior teeth is often required as the final step of orthodontic therapy to optimize the esthetics and function. This case report presents a direct minimally invasive approach for post-orthodontic recontouring of anterior teeth using the composite injection technique with a digital workflow. CLINICAL CONSIDERATIONS: The extraction of central incisors with short roots was indicated to resolve maxillary anterior crowding. The gained space was closed with lateral incisors, and it was necessary to recontour them and canines to resemble central and lateral incisors, respectively. The restorations were digitally designed, and a transparent silicone index was fabricated from a 3D-printed cast of the digital wax-up. After lateral incisors and canines were bonded with a universal adhesive in the etch-and-rinse mode, a highly filled injectable composite resin was applied into the index. The restorative treatment was preceded by gingivectomy using an Er:YAG laser and home bleaching. CONCLUSIONS: In cases where more complex recontouring of anterior teeth is necessary, the composite injection technique could be a suitable alternative to indirect restorations, because it is straightforward, cost-effective, and does not require any preparation. The digital workflow simplified and expedited the treatment while contributing to its precision. CLINICAL SIGNIFICANCE: Post-orthodontic recontouring using direct composite restorations is well accepted by patients due to low cost and non-invasiveness. However, in complicated cases, the free-hand technique is time-consuming and technique-sensitive. The presented composite injection technique with a digital workflow significantly simplifies and expedites the composite placement while predictably enhancing the treatment outcome.

Topics & Concepts

Maxillary central incisorAnterior teethComposite numberGingivectomyDentistrySiliconeOrthodonticsWorkflowMaterials scienceMedicineComputer scienceComposite materialDatabaseDental materials and restorationsLaser Applications in Dentistry and MedicineOrthodontics and Dentofacial Orthopedics