19/04/2022

Closing Diastemas with Vittra APS Unique

Author: Dr. Carlos Eduardo Agostini Balbinot

Male patient, 17 years old.

MAIN COMPLAINT: Dissatisfaction with the smile due to the presence of a diastema between the upper central incisors.

INITIAL EVALUATION

Upon the initial clinical examination, no carious lesions were observed, and the patient had perfect periodontal health. A diastema of 2 mm was noted between the upper central incisors, with the left upper central incisor slightly inclined in relation to its long axis, but still in a favorable situation for closing the diastema. The patient did not express any concerns regarding the color of his teeth.

Fig 1 Aspecto inicial do sorriso — Fig. 1 – Initial appearance of the smile.

Fig 2 Aspecto inicial intra-oral com contraste — Fig. 2 – Initial intraoral appearance with contrast.

TREATMENT EXECUTED

A prophylaxis was performed using pumice, followed by a restoration trial with the monochromatic composite resin Vittra APS Unique. This was done without isolating the operative field and without performing a prior adhesive procedure, so that the patient could assess the intended outcome in terms of both shape and color change of the restorations. After the patient agreed to the proposed treatment, a modified absolute isolation of the operative field was performed.

An adhesive procedure was conducted, starting with the application of 37% phosphoric acid (Condac 37) to fully condition tooth 21, followed by the application of the Ambar APS adhesive system. Polymerization was done for 10 seconds, and then the Vittra APS Unique composite resin was placed.

Fig 3 Isolamento absoluto modificado do campo operatório — Fig 3 Modified absolute isolation of the operative field.

Fig 4 Proteção dos dentes adjacentes com TEFLON para realização de procedimento adesivo no dente 21 — Fig 4 Protection of adjacent teeth with TEFLON for adhesive procedure on tooth 21.

Fig 5 Resina composta Vittra APS Unique antes da fotopolimerização. — Fig 5 Vittra APS Unique composite resin before photopolymerization.

Fig 6 Resina composta Vittra APS Unique após a fotopolimerização — Fig 6 Vittra APS Unique composite resin after photopolymerization.

Fig 7 Restauração do dente 21 após acabamento com disco de lixa Diamond Pro — Fig 7 Restoration of tooth 21 after finishing with Diamond Pro abrasive disc.

Fig 8 Dente 11 após lavagem do ácido fosfórico 37% Condac 37 para posterior aplicação sistema adesivo Ambar APS — Fig 8 Tooth 11 after rinsing with 37% phosphoric acid Condac 37 for subsequent application of Ambar APS adhesive system.

Fig 9 Final imediato antes da remoção do isolamento absoluto modificado — Fig 9 Immediate final result before removal of modified rubber dam isolation.

After the photopolymerization of the final resin increment used on tooth 21, finishing was carried out using Diamond Pro abrasive discs, followed by polishing with abrasive rubber points and Diamond Flex felt discs, along with Diamond Excel polishing paste. Once the restoration of tooth 21 was completed, the restoration of tooth 11 was performed, following the same technical sequence and using a tensioned polyester matrix strip to achieve a smooth proximal surface and proper contact with tooth 21. After the completion of the restoration on tooth 11, finishing and polishing procedures were conducted, and the patient was scheduled for a follow-up evaluation in 7 days.