Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 27 Feb 2024

Polychromatic Restoration of Anterior Fractured Teeth Using a Custom-made Silicone Matrix

,
, and
Page Range: 119 – 126
DOI: 10.2341/23-097-T
Save
Download PDF

SUMMARY

When restoring anterior teeth using resin composites, the use of silicone guide matrices obtained from diagnostic wax-ups is recommended, as this technique facilitates layering and optimizes working time. This is particularly important in polychromatic layering and when more than one anterior tooth is to be restored with resin composites. However, in cases of fractured anterior teeth, it is often not feasible to perform a previous impression and waxing. In these cases, due to trauma and related psychological aspects, patients usually seek immediate esthetic solutions. Therefore, an interesting restorative approach that can simplify the restorative technique is the creation of a silicone guide matrix obtained from the patient’s fractured tooth, without the need for prior waxing. This type of personalized matrix was initially proposed by Bertholdo, Ricci, and Barrote. Thus, the purpose of the present work is to demonstrate a modification of the technique for making this type of custom-made matrix for the restoration of two upper central incisors of a 14-year-old patient who fractured his teeth in a bicycle accident.

Copyright: 2024
Figure 1.
Figure 1.

Initial aspect of the patient showing coronal fractures of both maxillary central incisors. Note the lesion in the lower lip. Also note the interocclusal relationship between mandibular and maxillary incisors.

Figure 2.
Figure 2.

Lateral view of the smile in which it is possible to observe the position of the mandibular central incisors in relation to the maxillary ones, especially at the areas of the fractures.

Figure 3.
Figure 3.

First impression using a putty PVS material.

Figure 4.
Figure 4.

The first impression was relined with a light PVS material.

Figure 5.
Figure 5.

Copy of the mandibular teeth after relining the initial impression.

Figure 6.
Figure 6.

The facial surface of the mold was removed using the incisal-facial line angle of the sound teeth as reference.

Figure 7.
Figure 7.

Evaluation of the matrix on the patient’s mouth. Note that the incisal edges were drawn with a pencil. The mesial facial-interproximal line angles were used as references.

Figure 8.
Figure 8.

Sculpture of the palatal surfaces of the fractured teeth using Maxicut and Minicut drills.

Figure 9.
Figure 9.

Drawing showing the step-by-step procedure to produce the custom-made PVS matrix.

Figure 10.
Figure 10.

Sculpture of the palatal surface with an achromatic enamel shade.

Figure 11.
Figure 11.

Aspect of the sculpted palatal surfaces.

Figure 12.
Figure 12.

After sculpture of the dentin mamelons, an opalescent shade was added between the mamelons.

Figure 13.
Figure 13.

The final layer with an A1 enamel shade.

Figure 14.
Figure 14.

The facial-interproximal line angles were marked with a red pencil.

Figure 15.
Figure 15.

Adjustment of the buccal-interproximal line angles with a coarse polishing disk.

Figure 16.
Figure 16.

Developmental grooves were created with a fine diamond bur.

Figure 17.
Figure 17.

The same fine diamond bur was used to produce ripples and stipples.

Figure 18.
Figure 18.

Initial polishing with a silicon carbide brush.

Figure 19.
Figure 19.

Removal of interproximal excesses with a #12 scalpel blade.

Figure 20.
Figure 20.

The palatal surfaces were polished with sequential rubber disks, while the final polishing was obtained with flexible felt disks and polishing paste.

Figure 21.
Figure 21.

Final result after polishing.

Contributor Notes

*Corresponding author: Departamento de Dentística, Endodontia e Materiais Odontológicos, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Alameda Dr Octávio Pinheiro Brisola, 9-75, CEP 17012-901, Bauru, SP, Brazil; e-mail: furuse@usp.br
Accepted: 18 Dec 2023
  • Download PDF