03 Sep Maxillary anterior region make-over with Polydentia anterior matrices – Dr. Marina Papachroni
Maxillary anterior region make-over with Polydentia anterior matrices
Dr. Marina Papachroni
Dr. Marina Papachroni
Marina Papachroni graduated in 1995 from dental school at the University of Athens. She completed a three-year post-graduate program where she received her paediatric dentistry specialisation certificate in 1999 and a two-year master’s degree in dental materials in 2001 from the same university. Thereafter, she has attended numerous congresses, courses, and continuing education programs. She is the Treasurer of the Board of the Hellenic Academy of Clinical Dentistry and a member of the Hellenic Society of Paediatric Dentistry, the European Academy of Paediatric Dentistry, and the International Association of Paediatric Dentistry.
Lately, she lectures on Bioactive Materials, Restorative Paediatric Dentistry and Pulp Therapy of Primary teeth. The current focus of clinical research is Bioactive Restorative Materials. Dr Papachroni runs her private practice in Patras, Greece, emphasising aesthetic and microscopic paediatric dentistry.
clinical case
A teenage patient came to the practice to change the appearance of her maxillary anterior teeth before the start of orthodontic treatment. The maxillary sectors and canines showed dyschromatic and hypoplastic areas as shown in the initial image below, while the premolars and permanent molars were less affected.
We decided to restore these teeth using a common approach. We removed only enough tooth substance to achieve homogeneous substrate shade. We then proceeded to direct teeth reconstruction through composite resin build-ups using Dentin Bi2 (Inspiro) and Enamel SW (Inspiro).
The following case shows direct composite restorations of several maxillary anterior teeth and illustrates how the choice of an appropriate matrix, which fits the small size of young teeth and/or partially erupted teeth, leads to anatomically correct results.
In this case we used three matricing solutions by Polydentia, including the anterior matrices of the Unica anterior matrix system, Unica anterior and the new minideep version, as well as a Tofflemire contoured transparent matrix band.
1: Preoperative situation. The image shows the maxillary anterior region affected by dyschromia and enamel hypoplasia.
2: Labial view of the initial situation showing the maxillary anterior region.
3: The anterior region under rubber dam isolation.
4: View of maxillary canine #13 under isolation. We started the treatment by this tooth.
5: The partially erupted canine was restored using a transparent contoured Tofflemire band (Polydentia) as it provided the best adaptation to the wider profile of this tooth, and it matched effectively the undefined cervical part due to the eruption process.
6: The restored cervical and proximal margins of canine #13. As specified in the introduction of this clinical case we restored this tooth using direct composite resin, namely Dentin Bi2 and Enamel SW (Inspiro).
7: Maxillary lateral incisor #12 is the next tooth to be restored. Matrixing was performed using the new Unica minideep anterior matrix (Polydentia). This matrix offers an ideal adaptation for smaller anterior teeth, so it is also very suitable for paediatric restorations of young permanent teeth.
8: The image shows all dental margins – proximal and cervical – ideally sealed.
We can appreciate how the matrix (Unica minideep anterior, Polydentia) allows to obtain an efficient gingival retraction, making the restoration predictable and the cervical margin straightforward to manage.
9: Reconstruction of the margins with composite resin. Thanks to the unique geometry of the matrix (Unica minideep anterior, Polydentia), we are able to shorten the restoration time and optimize its costs since we could reconstruct the margins – proximal and cervical – in one step and with only one matrix.
10: Composite build-up of #12. The image shows the tooth with the reconstructed proximal and cervical margins in relief.
11: View of the maxillary left lateral incisor #22 to be restored.
12: In the same fashion, we proceeded to directly restore this lateral incisor using Unica minideep anterior matrix (Polydentia).
13: Margins reconstruction. The image allows us to appreciate the malleability of the alloy of the new Unica minideep anterior matrix (Polydentia), thanks to which we were able to efficiently add composite material to create a more anatomical incisal edge.
14: View of the two central incisor #11 and #21 prior the restorative procedure. We can appreciate the difference between the pleasant-looking lateral incisor and the dischomia affected.
15: For the restorations of these teeth, we opted for Unica anterior matrix (Polydentia). With this matrix we obtained maximum adaptation as it was specially developed to fit maxillary central incisors.
16: Preparation step showing the etching process.
17: Proximal and cervical margin reconstructions. Like Unica minideep anterior matrix, Unica anterior matrix allows us to manage the proximal and cervical margins with ease.
18: This picture illustrates the two central incisors with both proximal and cervical margins restored and in relief.
19: Labial view of the operative field. The last tooth left to be restored is the maxillary canine #23.
20: For the restoration of this canine #23, Optragate was used instead of isolation with rubber-dam because the anterior gums were quite damaged. The time between appointment was not sufficient for adequate healing.
21: Tooth matricing with a Tofflemire contoured transparent matrix (Polydentia).
22: Etching prior to composite resin build-up stage.
23: Immediate final situation after the restorative treatment. We can appreciate the anatomically correct and aesthetic restorations of the maxillary anterior region.
24: Immediate final situation after the restorative treatment.
25: Immediate final situation after the restorative treatment.
26: View of the restored anterior region after 1 week from treatment.
27: Lateral view of the restored anterior region 1 week after treatment. The image shows the harmony of shape and colour of the upper and lower arch elements.
28: View of the restored anterior region after 1 week from treatment.
29: View of the restored anterior region after 1 week from treatment.
30: View of the restored anterior region after 1 week from treatment.
31: Comparison image of the maxillary anterior region before and after the restorative treatment.
32: Lateral view of the restored maxillary teeth.
conclusioni
The careful choice and customisation of anterior matrices allows the correct adaptation to the different morphologies and sizes of the anterior teeth. This is particularly true for paediatric dentistry as restorations can be challenging due to the different sizes and shapes of young permanent teeth, especially when the cervical margin is not yet well defined due to the eruption process.
In this case we used three different Polydentia matrices to perform direct restorations with composite veneers: Unica anterior matrix, the new Unica minideep anterior matrix and a Tofflemire contour transparent band. These matrices represent versatile solutions that adapt well and can be customised to the different morphologies of young permanent teeth. By using these matrices for my paediatric direct composite restorations, I can save chair-time and optimise treatment costs.
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https://download.polydentia.ch/file/casi-clinici/en/mktg-0160-cc-en-papachroni-maxillary-anterior.pdfproducts used
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This product has multiple variants. The options may be chosen on the product page
Unica minideep anterior matrix
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This product has multiple variants. The options may be chosen on the product page
Unica anterior matrix
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This product has multiple variants. The options may be chosen on the product page
Tofflemire Contoured Transparent Matrices
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