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Esthetic
Restorations—
When Cost Is a Factor
The
Clinician is sometimes faced with the dilemma of creating
an esthetic and functional restoration for patients who
cannot afford optimal dentistry.
One
such patient, Figure 1, asked to have his upper right peg
lateral incisor corrected. Full coverage with either a porcelain
jacket crown or a porcelain fused to gold crown was not
feasible for financial reasons, so an alternative method
was devised to provide esthetics with moderate functional
capabilities.
TECHNIQUE
An
acid-etch type composite material was used in this procedure.*
The preparation of the tooth consisted of cutting a chamfer
below the gingival margin and also roughening the enamel
slightly over the entire tooth. Since the margin is below
the gingiva, this allows an optimal caries-free environment
at the interface between the material and the tooth.
Contrary
to the manufacturer's instructions, the acid was applied
to the entire enamel surface twice to afford greater etching.
The material was mixed and placed in a clear plastic crown
form and seated slightly past the chamfer.
It
was allowed to set an extra two minutes, due to the bulk
of the material, before the crown form was cut off.
The
restoration was then shaped and finished. For assurance
against fracture of the incisal edge, 1mm of material was
left over the incisal edge of the prepared tooth, Figure
2.
The
patient has been instructed to avoid incision of hard food
with this anterior tooth and avoid stain-producing foods.
The restoration has been in the mouth more than ten months
with no signs of deterioration or decay.
*Restodent,
Lee Pharmaceuticals, S. El Monte, California.
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