Clinical strategies for esthetic excellence in anterior tooth restorations: understanding color and composite resin selection

Abstract

Direct composite resin restorations have become a viable alternative for patients that require anterior restorative procedures to be integrated to the other teeth that compose the smile, especially for presenting satisfactory esthetic results and minimum wear of the dental structure. Technological evolution along with a better understanding of the behavior of dental tissues to light incidence has allowed the development of new composite resins with better mechanical and optical properties, making possible a more artistic approach for anterior restorations. The combination of the increasing demand of patients for esthetics and the capacity to preserve the dental structure resulted in the development of different incremental techniques for restoring fractured anterior teeth in a natural way. In order to achieve esthetic excellence, dentists should understand and apply artistic and scientific principles when choosing color of restorative materials, as well as during the insertion of the composite resin. The discussion of these strategies will be divided into two papers. In this paper, the criteria for color and material selection to obtain a natural reproduction of the lost dental structures and an imperceptible restoration will be addressed.

Avaliação da fluorescência das resinas compostas para esmalte e dentina de diferentes marcas comerciais

“…Em resultado disso, há a evolução das resinas compostas, nas quais foram feitas modificações físicas e ópticas para melhorar seu desempenho, fazendo com que as restaurações ficassem o mais semelhante possível aos dentes adjacente [1] .…”

“…Esta fluorescência é policromática e é mais evidente quando os dentes naturais são expostos sob luz negra, como nas discotecas, luz solar, carga das diferentes marcas comerciais assim como a adição de pigmentos. Estes são fatores relevantes para chegar o mais próximo das características ópticas das estruturas dentais [1] .…”

Cosmetic contour: minimally invasive cosmetic reformulation

“…This incremental approach allows for a perfect masking of the limits between tooth and restoration, and for a more precise reproduction of the optical, physical, and mechanical characteristics of each dental substrate. 10 In cosmetic contouring, it is paramount that the clinician is trained to observe fundamental aspects and details for an adequate planning and execution of a correct esthetic As a general rule, translucent resins work as an artificial enamel, whereas opaque resins work as an artificial dentin. From this perspective, one must determine the area where each type of composite resin will be applied, according to its mechanical and optical behavior characteristics, as well as the thickness of the layers, in order to maximize the esthetic results.…”

“…This characterization is obtained from the contrast of convex and concave areas. 10 Finally, the integration of the restoration to the patient's gums, lips, smile, and face is fundamental for the esthetic success of the restoration procedure. The size of a tooth is relevant not only for its own esthetics, but also for the esthetics of the face.…”

Avaliação clínica retrospectiva de restaurações cervicais de resina composta

“…Diante do seu rápido aperfeiçoamento, combinado com o uso dos sistemas adesivos, a resina composta hoje em dia é utilizada na maioria das restaurações estéticas diretas em dentes anteriores 3,8 , solucionando um número cada vez maior de situações clínicas de alterações de função, forma e estética [8][9][10] , sob um conceito de intervenção operatória minimamente invasiva 11 . Contudo, o profissional deve conhecer os limites do material para oferecer e optar pelo melhor tratamento diante desses casos de reabilitação.…”