Maxillary Anterior Esthetic Rehabilitation of Twin Patients Following Orthodontic Treatment - Case Reports

Yıl 2024, Cilt: 6 Sayı: 2, 241 - 249, 30.08.2024

Cansu Atalay , Esra Ergin

https://doi.org/10.51122/neudentj.2024.108

Öz

Aim: These case reports detail the treatment of multiple diastemas, peg-shaped lateral incisors and gingival asymmetries in the maxillary anterior areas of twin patients.
Case Report: Two 21-year-old female twin patients (D.C.&T.C) visited our clinic to address their concern about gaps between maxillary anterior teeth. The teeth were vital and the surrounding tissues were healthy. In all cases, gingivectomy were performed using a 940 nm diode laser. Following a 14-day recovery time, the patient had diastema closure (D.C) and peg-shaped lateral incisors shaping (T.C) treatments. After choosing the shade, teeth were isolated using a rubber dam, no preparations were performed. G2-Bond Universal adhesive (GC) and a universal resin composite (G-aenial ACHORD, GC) were applied for restorative procedure and polymerized using an LED device for 20s. Subsequently, the macro and micro surface morphologies on the buccal surfaces were created and any occlusal interferences were checked. The restorations underwent polishing using polishing discs, silicone rubber polishers, and polishing strips. The patients were motivated to maintain dental hygiene and were told about the need for follow-up appointments.
Results: Following the restorative procedures, the patients expressed contentment with their physical appearances. During the 24-month follow-up, there were no signs of discoloration or chipping on the restorations, and the gingival contours were found to be satisfactory.
Conclusion: The utilization of laser aided gingivectomy in conjunction with direct composite resin make-ups resulted in the achievement of a balanced and aesthetically pleasing alignment of the teeth. Moreover, it is a prudent strategy for adolescent patients who have finished orthodontic treatment.

Anahtar Kelimeler

Diastema closure, Peg-shaped lateral, Anterior esthetic, Resin composite

İkiz Hastalarda Ortodontik Tedavi Sonrası Üst Anterior Dişlerin Estetik Rehabilitasyonu - Olgu Raporları

Öz

Amaç: Bu olgu raporları, ikiz hastaların maksiller ön bölgelerindeki çoklu diastemaların, kama şekilli yan kesici dişlerin ve diş eti asimetrilerinin tedavisini detaylandırmaktadır.
Olgu Raporu: 21 yaşında iki kadın ikiz hasta (D.C.&T.C), üst ön dişler arasındaki boşluklarla ilgili endişelerini gidermek için kliniğimizi ziyaret etti. Dişler canlıydı ve çevre dokular sağlıklıydı. Tüm vakalarda, gingivektomi 940 nm diyot lazer kullanılarak yapıldı. 14 günlük iyileşme sürecinin ardından hastaya diastema kapama (D.C) ve kama şekilli lateral diş şekillendirme (T.C) tedavileri uygulandı. Renk seçiminin ardından dişler bir lastik örtü kullanılarak izole edildi ve herhangi bir preparasyon yapılmadı. Restoratif prosedür için G2-Bond Üniversal adeziv (GC) ve üniversal kompozit rezin (G-aenial ACHORD, GC) uygulandı ve bir LED cihazı kullanılarak 20 saniye süresince polimerize edildi. Daha sonra bukkal yüzeylerdeki makro ve mikro yüzey morfolojileri oluşturuldu ve okluzal temaslar kontrol edildi. Restorasyonlara polisaj diskleri, silikon kauçuk lastikler ve kompozit zımparaları kullanılarak polisaj uygulandı. Hastalar oral hijyenlerini koruma konusunda motive edildi ve takip randevularının gerekliliği anlatıldı.
Bulgular: Restoratif prosedürlerin ardından hastalar fiziksel görünümlerinden memnun olduklarını ifade ettiler. 24 aylık takipte restorasyonlarda herhangi bir renk değişikliği veya kopma görülmedi ve diş eti konturlarının tatmin edici olduğu görüldü.
Sonuç: Lazer destekli gingivektominin direkt kompozit rezin restorasyonlar ile birlikte uygulanması, dişlerde estetik açıdan hoş bir dizilimin elde edilmesiyle sonuçlandı. Bu kombine tedavi şekli, ortodontik tedavisi henüz sonlanmış ergen hastalar için de ideal bir stratejidir.

Anahtar Kelimeler

Diastema kapama, Kama şekilli lateral, Anterior estetik, Kompozit rezin

Kaynakça

• Frese C, Schiller P, Staehle HJ, Wolff D. Recontouring teeth and closing diastemas with direct composite buildups: a 5-year follow-up. J Dent. 2013;41:979-85.
• Ferracane JL. Resin composite--state of the art. Dent Mater. 2011;27:29-38.
• Pereira Sanchez N, Powers JM, Paravina RD. Instrumental and visual evaluation of the color adjustment potential of resin composites. J Esthet Restor Dent. 2019;31:465-70.
• Suh YR, Ahn JS, Ju SW, Kim KM. Influences of filler content and size on the color adjustment potential of nonlayered resin composites. Dent Mater J. 2017;36:35-40.
• Capodiferro S, Kazakova R. Laser-Assisted Gingivectomy to Treat Gummy Smile. Dent Clin North Am. 2022;66:399-417.
• Maboudi A, Fekrazad R, Shiva A, Salehabadi N, Moosazadeh M, Ehsani H, et al. Gingivectomy with Diode Laser Versus the Conventional Scalpel Surgery and Nonsurgical Periodontal Therapy in Treatment of Orthodontic Treatment-Induced Gingival Enlargement: A Systematic Review. Photobiomodul Photomed Laser Surg. 2023;41:449-59.
• Korkut B, Yanikoglu F, Tagtekin D. Direct Midline Diastema Closure with Composite Layering Technique: A One-Year Follow-Up. Case Rep Dent. 2016;2016:1-5.
• Peumans M, Van Meerbeek B, Lambrechts P, Vanherle G. The 5‑year clinical performance of direct composite additions to correct tooth form and position. I. Esthetic qualities. Clin Oral Investig. 1997;1:12‑8.
• Demirci M, Tuncer S, Oztas E, Tekce N, Uysal O. A 4-year clinical evaluation of direct composite build-ups for space closure after orthodontic treatment. Clin Oral Investig. 2015;19:2187-2199.
• Kaizer MR, de Oliveira-Ogliari A, Cenci MS, Opdam NJ, Moraes RR. Do nanofill or submicron composites show improved smoothness and gloss? A systematic review of in vitro studies. Dent Mater. 2014;30:e41-78.
• G-aenial ACHORD, GC Corp Technical Manual. Available online: https://europe.gc.dental/en-GB/products/gaenialachord (accessed on 18 December 2022).
• Miao C, Yang X, Wong MC, Zou J, Zhou X, Li C, et al. Rubber dam isolation for restorative treatment in dental patients. Cochrane Database Syst Rev. 2021;5:CD009858.
• Tavelli L, Barootchi S, Stefanini M, Zucchelli G, Giannobile WV, Wang HL. Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting. Periodontol 2000. 2023;92:90-119.
• Aoki A, Mizutani K, Takasaki AA, Sasaki KM, Nagai S, Schwarz F, et al. Current status of clinical laser applications in periodontal therapy. Gen Dent. 2008;56:674-87;88-9, 767.
• Grzech-Lesniak K, Sculean A, Gaspirc B. Laser reduction of specific microorganisms in the periodontal pocket using Er:YAG and Nd:YAG lasers: a randomized controlled clinical study. Lasers Med Sci. 2018;33:1461-70.
• D'Arcangelo C, Di Nardo Di Maio F, Prosperi GD, Conte E, Baldi M, Caputi S. A preliminary study of healing of diode laser versus scalpel incisions in rat oral tissue: a comparison of clinical, histological, and immunohistochemical results. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:764-73.