Esthetic rehabilitation of darkened upper central incisor with direct veneer made of Vittra APS composite

Author: Prof. Dr. Fabio Cesar Lorenzoni

Clinical and radiographic examination
Darkening of element 11, which was the patient’s main complaint.

Radiographic examination revealed that element 11 presented canal treatment under satisfactory conditions and without periapical lesion. The patient reported that previous attempts at whitening did not achieve the desired result. The incisal edge of this tooth had been restored with composite resin.

The treatment
The proposed treatment was a direct veneer made of Vittra APS composite (FGM) associated with the cementation of a Whitepost fiberglass post (FGM) in order to improve the support of the restoration in composite resin. This treatment was based on the quality and quantity of the remaining dental structure.

Initial clinical situation demonstrating the evident darkening of element 11, withconsiderable esthetic damage.

Sequence of images presenting the clinical step-by-step of the adhesive cementation of the fiberglass posts. The “a” image shows the clinical verification of the Whitepost DC3 (FGM) fiberglass posts. The “b” image shows the dental substrate after application of the Ambar Universal adhesive (FGM) (previously the dental substrate was etched with Condac phosphoric acid 37% – FGM). The “c” image shows the mixer and applicator tip inserting the AllCem Core (FGM) dual resin cement and the “d” image shows the fiberglass post fitted inside the root canal after cement insertion.

Image presenting the shape of the dental preparation. Note dark spot in the center of the vestibular face.

After the modified absolute isolation, Ambar Universal adhesive (FGM) was applied to the tooth structure.

Reconstruction of the mesial and distal surfaces with Vittra APS resin (FGM) in DA1 and cervical region with DA2.

Final image after polishing with Diamond Pro (FGM) abrasive disks associated with Diamond Excel (FGM) polishing paste. This polishing consultation took place 7 days after esthetic rehabilitation.

Extraoral image showing the final result.

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