Young looking teeth

Aside from the necessary theoretical knowledge, working with composites also requires patience and manual skill. This especially applies to the anterior region. Here in particular, it is important to place the respective appropriate amount at the correct place and to apply the layers with particular care, to achieve the ideal clinical result. In work that requires an alteration, reconstruction or transformation, it is generally important to keep the desired target shape, design or image in mind. So the first step should involve a wax-up, an analysis of the smile from different perspectives, as well as consideration of the type of tooth to be formed. Naturally, the patient's concerns should also be taken into consideration when planning treatment.

Clinical case

In the case presented here, the patient expressed a desire for his teeth to be visible when speaking. It bothered him immensely that, in a resting position or half open, his lips totally covered his upper teeth. Furthermore, the patient refused any preparation of his teeth using grinding burs. This meant that possible treatment with ceramic veneers was out of the question. An additive wax-up and an occlusal analysis were carried out to check if it was possible to lengthen the anterior teeth with composites, as well as to create incisal edges with an opalescent effect and absorption materials for youthful-appearing teeth. To achieve such a youthful effect with composites, attention should be paid to the exact three-dimensional shape of the tooth. It should not be forgotten that a tooth characterised as youthful is more translucent and absorbs light in the blue or grey areas between the dentinal mamelons. Conversely, these mamelons reflect light especially in the incisal area. A smaller degree of light absorption effects can also occur in the approximal areas. In order to form these absorbent areas, we can use pigments or translucent composites. But it is most important to apply the dentine material, in a controlled fashion, from the cervical to the incisal areas, and to leave free spaces for translucent effects between the mamelons.