Case Study III

Successful Treatment for Fractured Restoration

Overview:

Restorations are the numerous ways in which your dentist can repair or restore lost teeth or missing elements of your dental structure, as well as components that need to be removed to prevent deterioration that could cause you discomfort in the future. Because of decay, degradation (weakening) of a previously installed restoration, or fracture of your tooth, the tooth structures may be missing. These issues can be resolved with dental restorations.

Patient details:

• Name:Rishab Anand

Symptoms:

No signs and symptoms were seen

Tests performed:

Initially, pulp vitality tests revealed that the central incisors (11,21) were vital. Radiographs recorded as part of the examination included the anterior maxillary region that showed no signs of periapical pathologies. Subsequently, dental curing light was used as a transilluminator, being placed on the lingual surface of 11,21 to evaluate the presence of cracks; this allowed visualization of horizontal cracks in the tooth. Hard and soft tissue examination revealed no underlying hard or soft tissue pathologies.

Diagnosis:

Fractured Restoration wrt 11,21

Treatment:

Following examination and diagnosis, because the lingual portion of the restoration was appropriately adapted wrt( 11), the selected treatment plan was to remove the buccal portion of the esthetic restoration, followed by repair of the vestibular surface with a composite resin wrt 11 and restoring the fractured segment wrt( 21) by using direct composite restoration technique.

Detailed description:

A 30-year-old male reported to the clinic with chief complaints regarding esthetics. The patient had reported trauma in the upper front teeth region 10 years back, met with an accident which leads to fractured teeth wrt 11,21. The patient’s past medical history did not reveal any significant findings. A class IV composite resin restoration involving an incisal corner present on the right maxillary central incisors (11) and a fractured segment wrt (21)were the teeth with the primary complaint.

For repair treatment, the composite resin shade was accurately selected with the help of a Vita scale and through direct color selection with the insertion and light-curing of small increments of resin on the tooth enamel. The selected color type for the nanohybrid universal composite restorative Filtek Z250 (3M ESPE) was A2 for the body and A2 for enamel. After removal of the buccal portion of the previous restoration wrt (11) with a diamond bur, the surface of the remaining composite was left slightly roughened with a diamond bur to facilitate adhesion. Subsequently, a 2-mm bevel was placed in a cavosurface margin by using a flame-shaped diamond bur. Adjacent teeth (12 and 22) were protected with Teflon tape.

Acid etching was done with 37% phosphoric acid for 10-15 sec rinsed thoroughly and dried. For repair, the nano filled composite Filtek Z250 (3M ESPE)was applied using incremental and stratified techniques with 2-mm-thick increments to reconstruct lost tooth faces. Initially, Filtek Z250 of color type A2 (for the body) was applied over the old existing restoration, taking care to slightly overlap the fracture line with the composite and to not extend this composite until the incisal margin. The composite increments were light-cured .

Then, a thin layer of Filtek Z250 of color type A2 (for enamel) was applied over the bevel until the incisal margin, the tooth shape was carved, and the composite was light-cured. The composite build-up was done incrementally on the labial surface and cured for 20 sec. wrt (21). An occlusal test was performed using carbon paper. During the same appointment, finishing and polishing of the restoration were achieved using multilaminate tips, Soft-lex discs Pop-on (3M ESPE). Subsequently, the restorations were polished using a felt disc and diamond paste from the direction of the composite resin toward the tooth.

Patient feedback:

It was a fantastic experience. Dr. Priyanka did restoration for me at Alright Dental Clinic. The clinic's atmosphere is really friendly, and Dr. Priyanka is quite laid-back. She patiently listens to your concerns before determining the best answer for you. It's definitely worth suggesting.