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Re-intervention on a restored fractured central incisor after one year of restoration replacement: from direct to indirect approach


Journal of Dental Health, Oral Disorders & Therapy
Carolina Bosso André,1 Bruna Marin Fronza,2 Marcelo Giannini3

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Abstract

This clinical report elucidates both uses of direct and indirect restoration techniques, in which a failure of the direct resin restoration after one year by tooth discoloration relapse was detected, and a ceramic veneer restoration was the final elected treatment. A poor marginal adaptation and mismatching color of a class IV resin composite restoration was observed, which was placed due to a traumatic dental injury, in which part of the enamel and dentin was lost but without tooth vitality impairment. Tooth bleaching was performed combining home and in-office bleaching techniques, followed by restoration replacement with resin composite in order to improve the dental esthetic. After one year of follow up, it was observed that the restored tooth was darker and the resin shade mismatch the tooth color, showing an evident restoration margin. In attempt to achieve a long lasting treatment, substitution of the direct composite by an indirect restoration was selected, using a unit ceramic veneer restoration, and followed up for four years. Conservative approaches should be the choice treatment in restorative dentistry, however the re-incidence of discolored tooth or the restoration material degradation must be taken into consideration before indicating a direct or indirect restoration.

Keywords

resin composite, laminate veneers, tooth bleaching, dental esthetic, dental trauma, radiographic evaluation, clinical examination, signs, symptoms, symptoms, restoration failure

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