Esthetic Rehabilitation of Bilateral Diastemas with Direct Resin Composite After Orthodontic Treatment: A Case Report

Abstract

Diastema between the maxillary anterior teeth is a frequent esthetic concern for many patients. Orthodontic, prosthetic and restorative treatment options are avaliable for closure of diastemas. In this case report, esthetic rehabilitation of anterior diastemas that could not be closed with orthodontic treatment was aimed with a minimally invasive approach using direct composite resin. A 22-year-old healthy female patient applied to the Restorative Dentistry Clinic with esthetic concerns following orthodontic treatment. Clinical and radiographic examination revealed caries on the mesial surfaces of teeth #12 and #21 and bilateral diastema between the upper central and lateral incisors. The decision was to close the diastemas using direct resin composite restorations. Following shade selection with button technique, initial photographs were taken, and the teeth were isolated with rubber-dam (Nictone, Mexico). Carious lesions on teeth #12 and #21 were removed using a 6-bladed tungsten carbide bur (Frank Dental, Germany). Enamel surfaces were etched with 35% orthophosphoric acid (Ultra Etch, Ultradent, USA) for 30 seconds and universal adhesive (G-Premio Bond, GC, Japan) was used according to manufacturer's instructions. A simply-shade supra-nanohybrid composite (Estelite Asteria A1B, Tokuyama, Japan) in the selected shade was applied to the teeth (#11, #12, #21, #22) using the layering technique. All polimerization steps were performed using the Valo Cordless (Ultradent, USA) light curing device (standart mode /1000 mW/cm2). Finishing and polishing were completed using discs (OptiDisc, Kerr, Switzerland) and two-stage polishing systems (Diacomp Plus Twist, Eve, Germany). The patient was recalled for a 6-mounth follow-up and scored according to FDI criteria.

Keywords

• Bilateral diastema
• minimally invasive
• resin composite restoration
• simply-shade

Ortodontik Tedavi Sonrası Bilateral Diastemaların Direkt Rezin Kompozit ile Estetik Rehabilitasyonu: Vaka Sunumu

Abstract

Üst çenede anterior dişler arasındaki diastema, hastalar arasında yaygın bir estetik kaygıdır. Diastemaların kapatılması için ortodontik, protetik ve restoratif tedavi uygulamaları seçenekler arasında yer alır. Bu vaka sunumunda ortodontik tedavi sonrası restoratif tedaviye ihtiyaç duyulan ön bölgedeki diastemaların direkt rezin kompozit kullanılarak minimal-invaziv yaklaşım ile estetik rehabilitasyonu amaçlanmıştır. 22 yaşında sağlıklı kadın hasta ortodontik tedavisi sonrasında estetik kaygılar nedeniyle Restoratif Diş Tedavisi Kliniğine başvurdu. Yapılan klinik ve radyografik muayenede #12 ve #21 numaralı dişlerin mezial yüzeylerinde çürük ve üst santral- lateral dişler arasında bilateral diastema tespit edildi. Diastemaların direkt kompozit rezin restorasyonlar ile kapatılmasına karar veridi. Buton tekniği ile renk seçimi yapıldıktan sonra başlangıç fotoğrafları alınarak dişler rubber-dam (Nictone, Meksika) ile izole edildi ve 6 bıçaklı tungsten karbid frez (Frank Dental, Almanya) kullanılarak çürükler (#12, #21) temizlendi. Mine yüzeyleri %35 ortofosforik asit (Ultra Etch, Ultradent, ABD) ile 30 saniye pürüzlendirildi ve üniversal adeziv ajan (G- Premio Bond, GC, Japonya) üretici talimatlarına göre uygulanarak 20 saniye boyunca polimerize edildi. Seçilen renkteki simply-shade supra nanohibrit kompozit (Estelite Asteria A1B, Tokuyama, Japonya) tabakalama tekniği ile dişlere (#11, #12, #21, #22) uygulandı. Tüm polimerizasyon işlemleri için Valo Cordless (Ultradent, ABD) ışıklı polimerizasyon cihazı standart modda (1000 mW/cm2) kullanıldı. Diskler (OptiDisc, Kerr, İsviçre) ve elmas emdirilmiş çift aşamalı polisaj sistemleri (Diacomp Plus Twist, Eve, Almanya) kullanılarak bitim ve polisaj işlemleri tamamlandı. Hasta 6. ay kontrolüne çağırılarak FDI kriterlerine göre skorlandı.

Keywords

• Bilateral diastema
• minimal invaziv
• rezin kompozit restorasyon
• simply-shade

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