engleski

Restoration of a Transpositioned Canine: Can an Intraoral Mock-up be too good?

Objective: The patient is often the final judge of restorations in esthetically driven treatment. Therefore it is important to accurately visualize the restorations before finalization. The intraoral composite mock-up is a technique in which composite resin is used freehand intraorally to contour one or more teeth and evaluate the affect on the patient’s appearance. But what if the patient aborts treatment because he doesn’t want anything better than the mock-up? Case presentation: A 22-year-old female presented dissatisfied with her front teeth and desired a “normal” smile. Clinical examination revealed tooth 23 transposed to the position of tooth 21 with soft tissue asymmetry. Shade analysis revealed an existing shade of A1 for the incisors and A3 for the transposed canine. Proposed treatment was to place a ceramic veneer. An intraoral mock-up was performed in order to show what enhancement could be achieved. The patient should wear the mock-up for a few days to allow scrutinizing the shade and form in “real-time” and prevent dissatisfaction after the final restoration is in place. To not overcontour the final restoration tooth 23 was prepared. IPS Empress Direct (Ivoclar Vivadent) composite material was used to shape an incisor with a layering technique. A natural color transition from tooth to restoration, masking of the darker underlying tooth, a natural surface texture, and a good overall blend-in with the adjacent structures was achieved. The patient was that satisfied with the result that after “test driving” her smile she refused to give it up. A 18-month follow-up revealed stable results. Conclusion: The placement of an intraoral mock-up empowers the clinician to create a dramatic aesthetic change in a single appointment. Can an intraoral mock-up be too good? The answer is no if the result is a happy patient and a dentist who gets acknowledgment for their esthetic skills.

intraoral mock up; esthetics; minimally invasive preparation

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