Author: Dr. Carlos Eduardo Agostini Balbinot
Male patient, 17 years old.
MAIN COMPLAINT: Dissatisfaction with the smile due to the presence of a diastema between the upper central incisors.
Upon the initial clinical examination, no carious lesions were observed, and the patient had perfect periodontal health. A diastema of 2 mm was noted between the upper central incisors, with the left upper central incisor slightly inclined in relation to its long axis, but still in a favorable situation for closing the diastema. The patient did not express any concerns regarding the color of his teeth.
A prophylaxis was performed using pumice, followed by a restoration trial with the monochromatic composite resin Vittra APS Unique. This was done without isolating the operative field and without performing a prior adhesive procedure, so that the patient could assess the intended outcome in terms of both shape and color change of the restorations. After the patient agreed to the proposed treatment, a modified absolute isolation of the operative field was performed.
An adhesive procedure was conducted, starting with the application of 37% phosphoric acid (Condac 37) to fully condition tooth 21, followed by the application of the Ambar APS adhesive system. Polymerization was done for 10 seconds, and then the Vittra APS Unique composite resin was placed.
After the photopolymerization of the final resin increment used on tooth 21, finishing was carried out using Diamond Pro abrasive discs, followed by polishing with abrasive rubber points and Diamond Flex felt discs, along with Diamond Excel polishing paste. Once the restoration of tooth 21 was completed, the restoration of tooth 11 was performed, following the same technical sequence and using a tensioned polyester matrix strip to achieve a smooth proximal surface and proper contact with tooth 21. After the completion of the restoration on tooth 11, finishing and polishing procedures were conducted, and the patient was scheduled for a follow-up evaluation in 7 days.