Direk rezin kompozit veneerler ile peg-lateral şeklindeki lateral kesici dişlerin tedavisi: İki Olgu Sunumu, İki Yıllık Klinik Takip

Yıl 2022, Cilt: 1 Sayı: 1, 30 - 36, 27.07.2022

Nurgül Çetin Çağatay Barutçugil

Öz

Amaç: Bu klinik raporun amacı, estetiği geliştirmek için peg şeklindeki lateral kesici dişlerin ve diastemaların tedavisinde direkt rezin bazlı kompozit veneerlerin iki farklı uygulamasının iki yıllık takiplerini sunmaktır.
Olgu Sunumu: Olgu 1: 32 yaşında kadın hasta, gülümsemesinin görünümünden şikayet ederek kliniğimize başvurdu. Klinik muayenede maksiller laretal kesici dişlerin peg lateral şeklinde olduğu ve rotasyon varlığı ile beraber hem maksiller hem de mandibular anterior dişlerde diastema varlığı tespit edildi. Peg lateral ve rotasyonlar ile diastemaların öncelikli olarak ortodonti tedavisi gerektirdiği, sonrasında ise indirekt porselen veneer veya direkt rezin kompozit veneer tedavisinin hastaya en uygun konservatif seçenek olduğu anlatıldı, ancak hasta ortodontik tedavi sürecini uzun bulduğu ve daha acil bir tedavi istediği için sadece direkt rezin kompozit veneer tedavisi planlandı.Tek seansta peg lateral dişler direkt rezin kompozit veneerle restore edildi.
Olgu 2: 15 yaşında kadın hasta, ortodontik tedavi bitimi sonrası maksiller lateral dişlerindeki mikrodonti ve diastema şikayetiyle kliniğimize başvurdu. Klinik muayenede maksiller laretal kesici dişlerin peg lateral şeklinde olması nedeniyle ortodontik tedavinin diastemalı olarak bitirildiği ve santral kesici dişlerin mesiallerindeki eski restoyanların renklendiği tespit edildi. Hastanın yaşının genç olması nedeniyle eski restorasyonların değiştirilmesi ve diastemaların kapatılması için direkt rezin kompozit veneer tedavisinin hastaya en uygun konservatif seçenek olduğu anlatıldı. Tedavi planının hasta ve evebeyni tarafından onaylanmasının ardından onam alınarak tek seansta peg lateral dişler ve diastemalr direkt rezin kompozit veneerle restore edildi.
Her iki vakada iki yıllık takip randevusunda restorasyonda hiçbir kırılma, marjinal renk değişikliği veya sekonder çürük görülmedi. Hastalar rezin kompozit veneerlerden hem estetik hem de fonksiyonel açıdan oldukça memnun kaldı.
Sonuç: Direkt rezin kompozit veneer tedavi prosedürürü, anterior dişlerin estetiğini geri kazandırmak için uygun maliyetli bir tedavi alternatifi olmasının yanında, daha invaziv restorasyonlar düşünülmeden önce özellikle büyüme gelişimi devam eden ve ileri yaştaki ortodontik tedaviyi tolere edemeyen hastalarda ilk düşünülmesi gereken konservatif bir yaklaşımdır.

Anahtar Kelimeler

maksiller peg lateral, Diestema, direkt rezin kompozit

Treatment of peg-lateral shaped lateral incisors with direct resin composite veneers: Two Case Reports, Two-Year Clinical Follow-up

Öz

Aim: The aim of this clinical report is to present two-year follow-ups of two different applications of direct resin-based composite veneers in the treatment of peg-shaped lateral incisors and diastemas to improve esthetics.
Case report: Case 1: A 32-year-old female patient applied to our clinic complaining about the appearance of her smile. In the clinical examination, it was determined that the maxillary laretal incisors were peg lateral and there was rotation as well as the presence of diastema in both maxillary and mandibular anterior teeth. It was explained to the patient that peg lateral and rotations and diastemas primarily required orthodontic treatment, and then indirect porcelain veneer or direct resin composite veneer treatment was the most suitable conservative option for the patient. Peg lateral teeth were restored with direct resin composite veneer in a single session.
Case 2: A 15-year-old female patient applied to our clinic with the complaints of microdontia and diastema in her maxillary lateral teeth after the end of orthodontic treatment. In the clinical examination, it was determined that the orthodontic treatment was completed with diastema due to the peg lateral shape of the maxillary laretal incisors, and the old restorants on the mesial of the central incisors were discolored. Due to the young age of the patient, direct resin composite veneer treatment was the most appropriate conservative option for replacing old restorations and closing diastemas. After the treatment plan was approved by the patient and the parents, the peg lateral teeth and diastemal were restored with a direct resin composite veneer in a single session.
In both cases, no fracture, marginal discoloration, or secondary caries were observed in the restoration at the two-year follow-up appointment. The patients were very satisfied with the resin composite veneers both aesthetically and functionally.
Conclusion: Direct resin composite veneer treatment procedure, besides being a cost-effective treatment alternative to restore the aesthetics of anterior teeth, is a conservative approach that should be considered first, especially in patients whose growth development continues and who cannot tolerate orthodontic treatment at an advanced age before considering more invasive restorations.

Anahtar Kelimeler

maxillary peg lateral, direct resin composite, diastema

Kaynakça

• 1. Montero J, Gomez Polo C, Rosel E, Barrios R, Albaladejo A, Lopez-Valverde A. The role of personality traits in self-rated oral health and preferences for different types of flawed smiles. J Oral Rehabil. 2016;43(1):39-50.
• 2. Rosenstiel SF, Rashid RG. Public preferences for anterior tooth variations: a web-based study. J Esthet Restor Dent. 2002;14(2):97-106.
• 3. Parrini S, Rossini G, Castroflorio T, Fortini A, Deregibus A, Debernardi C. Laypeople's perceptions of frontal smile esthetics: A systematic review. Am J Orthod Dentofacial Orthop. 2016;150(5):740-50.
• 4. Rosa M, Olimpo A, Fastuca R, Caprioglio A. Perceptions of dental professionals and laypeople to altered dental esthetics in cases with congenitally missing maxillary lateral incisors. Prog Orthod. 2013;14:34.
• 5. Schmitz JH, Coffano R, Bruschi A. Restorative and orthodontic treatment of maxillary peg incisors: a clinical report. J Prosthet Dent. 2001;85(4):330-4.
• 6. Peck S, Peck L, Kataja M. Prevalence of tooth agenesis and peg-shaped maxillary lateral incisor associated with palatally displaced canine (PDC) anomaly. Am J Orthod Dentofacial Orthop. 1996;110(4):441-3.
• 7. Kook YA, Park S, Sameshima GT. Peg-shaped and small lateral incisors not at higher risk for root resorption. Am J Orthod Dentofacial Orthop. 2003;123(3):253-8.
• 8. Ittipuriphat I, Leevailoj C. Anterior space management: interdisciplinary concepts. J Esthet Restor Dent. 2013;25(1):16-30.
• 9. Omeish N, Nassif A, Feghali S, Vi-Fane B, Bosco J. Esthetic and functional rehabilitation of peg-shaped maxillary lateral incisors: Practical recommendations. Clin Case Rep. 2022;10(3):e05507.
• 10. Bozkaya E, Canigur Bavbek N, Ulasan B. New perspective for evaluation of tooth widths in patients with missing or peg-shaped maxillary lateral incisors: Quadrant analysis. Am J Orthod Dentofacial Orthop. 2018;154(6):820-8.
• 11. Pini NI, Marchi LM, Pascotto RC. Congenitally missing maxillary lateral incisors: update on the functional and esthetic parameters of patients treated with implants or space closure and teeth recontouring. Open Dent J. 2014;8:289-94.
• 12. Robertsson S, Mohlin B. The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment. Eur J Orthod. 2000;22(6):697-710.
• 13. Lameira C, Mestrener SR, Pini N, Salomao FM, Pesqueira AA, Fagundes TC. Conservative Approach for Treatment of Maxillary Lateral Incisor Agenesis With the Deciduous Tooth Retained: 18-Month Follow-Up. Oper Dent. 2018;43(2):121-7.
• 14. Miller WB, McLendon WJ, Hines FB, 3rd. Two treatment approaches for missing or peg-shaped maxillary lateral incisors: a case study on identical twins. Am J Orthod Dentofacial Orthop. 1987;92(3):249-56.
• 15. Scarpelli AC, Reboucas AP, Compart T, Novaes-Junior JB, Paiva SM, Pordeus IA. Seven-year follow-up of esthetic alternative for the restoration of peg-shaped incisors: a case study of identical twins. Gen Dent. 2008;56(1):74-7.
• 16. Lenhard M. Closing diastemas with resin composite restorations. Eur J Esthet Dent. 2008;3(3):258-68.
• 17. Kim Y-H, Cho Y-B. Diastema closure with direct composite: architectural gingival contouring. Journal of Korean Academy of Conservative Dentistry. 2011;36(6):515-20.
• 18. Hwang SK, Ha JH, Jin MU, Kim SK, Kim YK. Diastema closure using direct bonding restorations combined with orthodontic treatment: a case report. Restor Dent Endod. 2012;37(3):165-9.
• 19. Heymann H, Hershey H. Use of composite resin for restorative and orthodontic correction of anterior interdental spacing. The Journal of prosthetic dentistry. 1985;53(6):766-71.
• 20. Alberton SB, Alberton V, de Carvalho RV. Providing a harmonious smile with laminate veneers for a patient with peg-shaped lateral incisors. J Conserv Dent. 2017;20(3):210-3.
• 21. Magne P, Belser UC. Porcelain versus composite inlays/onlays: effects of mechanical loads on stress distribution, adhesion, and crown flexure. International Journal of Periodontics & Restorative Dentistry. 2003;23(6).
• 22. Nakamura T, Imanishi A, Kashima H, Ohyama T, Ishigaki S. Stress analysis of metal-free polymer crowns using the three-dimensional finite element method. International Journal of Prosthodontics. 2001;14(5).
• 23. Uchida H, Vaidyanathan J, Viswanadhan T, Vaidyanathan TK. Color stability of dental composites as a function of shade. The Journal of prosthetic dentistry. 1998;79(4):372-7.
• 24. Walls A, Murray J, McCabe J. Composite laminate veneers: a clinical study. Journal of oral rehabilitation. 1988;15(5):439-54.
• 25. De Munck Jd, Van Landuyt K, Peumans M, Poitevin A, Lambrechts P, Braem M, et al. A critical review of the durability of adhesion to tooth tissue: methods and results. Journal of dental research. 2005;84(2):118-32.