Comprehensive Oral Diagnosis and Management for Women with Turner Syndrome.

Turner Syndrome (TS) is a rare genetic disorder that affects females when one of the X chromosomes is partially or completely missing. Due to high genetic and phenotypic variability, TS diagnosis is challenging and is often delayed until adolescence, resulting in poor clinical management. Numerous oral, dental and craniofacial anomalies have been associated with TS, yet a comprehensive description is still lacking. This study addresses this gap through a detailed analysis of oral health and craniofacial characteristics in a cohort of 15 females with TS and their first-degree relatives. Subjects with TS ranged from 3 to 48 years old, none showed evidence of periodontal disease and only the youngest was in mixed dentition. Using the Multifunction System, we identified an aggregation of multiple signs and symptoms in each TS subject, including tooth anomalies (supernumerary molars, agenesis, microdontia, enamel defects, alterations in eruption patterns -advanced and delayed for chronological age-, crowding, rotations and transpositions), malocclusion (class II/1 and II/2) and Class II facial profile, while relatives exhibited fewer manifestations. The early detection of these signs and symptoms is crucial for appropriate referral and the optimal clinical management of TS, especially during the critical period of 9 to 10 years when congenital dental anomalies appear. The use of an established taxonomy to describe these phenotypic features is essential for early detection. Multidisciplinary teams are required to ensure holistic care management in rare diseases like TS.

Bilateral dens evaginatus and associated cystic pathology: An unusual case report.

Dens evaginatus (DE) presents a clinical conundrum due to its fragility and propensity to cause pulpal and periapical complications. Clinicians should heed the presence of DE during clinical examinations and avoid unnecessary intervention.

Componeer as an aesthetic treatment option for anterior teeth: a case report.

INTRODUCTION: Structural abnormalities or anomalies in the anterior teeth, also known as the aesthetic zone, are an important problem for patients and a challenge for dentists. Structural abnormalities or tooth anomalies can change in color, shape, and function. Most dentists prefer minimally invasive aesthetic treatment. One of the aesthetic treatment options for anterior teeth is veneers. Veneer is a restoration that covers the labial part of the tooth with a thin layer of material to correct abnormalities in the color, shape, or function of the tooth. Veneer restoration can be done indirectly with porcelain material made in a laboratory and directly with composite material on the tooth surface or prefabricated which is available from the factory. Componeer is a prefabricated composite veneer that combines the aesthetic properties of ceramic veneers and the adhesive ability of composite veneers to the tooth structure. This case report describes the treatment of two central incisors that had been filled with composite and peg shapes on both lateral incisors using a componeer. CASE REPORT: A 32-year-old female patient came to the Dental Conservation Clinic at Dentistry Hospital, Padjadjaran University with the main complaint of her right and left upper front teeth and wanted to repair her old fillings and close the gap between her right and left upper front teeth and her canine teeth. Clinical examination showed that teeth 11 and 21 had been filled with composite which had changed color and had an inharmonious shape as well as a gap between the upper front teeth on the right and left sides and the right and left canine teeth. TREATMENT: The maxilla and mandibular teeth are molded for study models and working models. In the working model, a wax-up is carried out, then a mock-up on the patient's teeth. Next, choose the color and size of the components that match the mock up results. Teeth 11 and 21 had their old composite fillings cleaned and refilled with dentin colored composite, teeth 13, 12, 11, 21, 22, and 23 were prepared with a minimum thickness of 0.3 mm to make room for the componeer material. The teeth was etched and bonded, and bonding was applied to the inner surface of the componeer. The composite is placed on the inner surface of the componeer then placed on the labial surface of the tooth and pressed with a special tool, then light cured. The final step is polishing. TREATMENT RESULTS: Teeth 13, 12, 11, 21, 22, and 23 which had undergone veneer treatment using componeer, were controlled after 1 week of treatment. The patient did not complain about the results of the treatment and said he was satisfied with the treatment.

Association between maxillary canine impaction and other dental anomalies: radiological study of a mixed dentition children's cohort from an orthodontic clinic.

PURPOSE: To investigate the significance of association between maxillary impacted canines and various dental anomalies. METHODS: Files of 874 orthodontic patients were evaluated for the presence of maxillary impacted canines. From this sample, a group of 97 patients (39 males and 58 females) with at least 1 impacted maxillary canine consisted the study group. This group was compared to a control group of 97 patients (42 males and 55 females) that was created by random selection from the initial sample without maxillary canine impaction. The impaction diagnosis was made from the panoramic radiographs. Chi-square test was used to perform the analysis for significant associations. Stepwise discriminant analysis, binary logistic regression and classification tree were used to identify best combinations. RESULTS: Statistically significant difference was found for peg-shaped maxillary lateral incisors and infraoccluded deciduous molars. The presence of peg-shaped upper lateral incisors arises the probability of impacted canine to 83.3%, a distal displaced unerupted second premolar to 63.16% and the impaction of any other teeth to 80% as showed by the classification tree. CONCLUSIONS: The presence of peg-shaped maxillary lateral incisors and infraocclusion of deciduous molars can be considered major valuable early risk indicators for maxillary canine impaction, because they manifest before the maxillary canine eruption. Special consideration should be given on distal displaced unerupted second premolar and the impaction of any other teeth. Patients with these dental anomalies are candidates for future interceptive treatment for canine eruption.

H4C5 missense variant leads to a neurodevelopmental phenotype overlapping with Angelman syndrome.

Recurrent de novo missense variants in H4 histone genes have recently been associated with a novel neurodevelopmental syndrome that is characterized by intellectual disability and developmental delay as well as more variable findings that include short stature, microcephaly, and facial dysmorphisms. A 4-year-old male with autism, developmental delay, microcephaly, and a happy demeanor underwent evaluation through the Undiagnosed Disease Network. He was clinically suspected to have Angelman syndrome; however, molecular testing was negative. Genome sequencing identified the H4 histone gene variant H4C5 NM_003545.4: c.295T>C, p.Tyr99His, which parental testing confirmed to be de novo. The variant met criteria for a likely pathogenic classification and is one of the seven known disease-causing missense variants in H4C5. A comparison of our proband's findings to the initial description of the H4-associated neurodevelopmental syndrome demonstrates that his phenotype closely matches the spectrum of those reported among the 29 affected individuals. As such, this report corroborates the delineation of neurodevelopmental syndrome caused by de novo missense H4 gene variants. Moreover, it suggests that cases of clinically suspected Angelman syndrome without molecular confirmation should undergo exome or genome sequencing, as novel neurodevelopmental syndromes with phenotypes overlapping with Angelman continue to be discovered.

Prevalence of Dental Anomalies in Taiwanese Children with Cleft Lip and Cleft Palate.

The aim of this study was to investigate the prevalence of tooth agenesis, tooth malformation, and eruption patterns of upper canines/first premolars in Taiwanese children. A total of 132 cleft lip and cleft palate (CLCP) patients (82 boys and 50 girls) underwent alveolar bone grafting (ABG) between 2012 and 2022. The patients' dental records and X-ray images were inspected. We examined dental anomalies, including congenital missing teeth, microdontia, and transposition from the upper canines to the upper first premolars in these CLCP patients. Additionally, we investigated the mean ABG operation age (9.27 ± 0.76 years) of our patient; 40.9% of them received pre-ABG orthodontic treatment at 8.72 ± 0.70 years. Among the 132 cleft subjects, the prevalence of tooth agenesis is 73.5% (97/132). The most frequently missing teeth are the maxillary lateral incisors (right side: 46.2%; left side: 47.0%). In this study, microdontia are found in all the upper incisors, of which the highest percentage (18.9%) is observed in the upper left lateral incisors. The prevalence of upper canine and first premolar transposition is 10.6%. The pattern of tooth agenesis and microdontia of the upper lateral incisors shows a strong correlation with the cleft sites of these CLCP patients in our study. These results may support the idea that the patterns of dental anomalies in CLCP patients are region-specific.

Concrescence of maxillary second molar and impacted third molar: A case report.

BACKGROUND: Morphological anomalies of teeth, including talon cusp, dens evaginatus, gemination, fusion, concrescence, root dilaceration, and taurodontism, always involve changes in the enamel, cementum and dentin. Diagnosing concrescent teeth through routine clinical examination alone is difficult, and most cases of concrescence are found accidentally during extraction. A definite preoperative diagnosis of concrescence would contribute to a better treatment plan and fewer undesirable complications. CASE SUMMARY: A 47-year-old woman who complained of left maxillary first molar loss for half a year presented to our department seeking treatment by dental implant restoration. Panoramic radiography and cone-beam computed tomography (CBCT) showed an unclear boundary between the distal root of the second molar and the mesial root of the third molar. The teeth were extracted under local anesthesia, and a definite diagnosis of concrescence was made by histopathological examination. CONCLUSION: CBCT is a useful tool for diagnosing and planning the management of tooth concrescence and may be beneficial for reducing unnecessary complications.

Fatores ambientais e variações genéticas nos genes AMBN, ENAM, KLK4, IRF6, TFGα em pacientes com hipomineralização molar incisivo / Environmental factors and genetic variations in the AMBN, ENAM, KLK4, IRF6, TFGα in patients with incisor molar hypomineralization

Trata-se de uma tese composta por quatro estudos, com o objetivo de avaliar possíveis fatores etiológicos (ambientais e genéticos) associados a presença de Hipomineralização Molar Incisivo (HMI) através de (a) : um estudo observacional transversal para verificar a prevalência de HMI na amostra estudada, junto com uma revisão bibliográfica da prevalência desta condição na população brasileira (objetivo-I); associação de fatores ambientais (durante o período gestacional e nos primeiros anos de vida) relacionados à presença de HMI e a influência destes fatores com a gravidade dessa condição (objetivo-II); associação dos polimorfismos de único nucletídeo (SNPs) localizados nos genes ameloblastina (AMBN), enamelina (ENAM) e calecreína com HMI, além da possível susceptibilidade dos SNPS com à cárie dentária (objetivo-III) e a interação entre fatores ambientais e as variações genéticas nos SNPs localizados nos genes fator 6 regulator de interferon (IRF6) e fator de crescimento transformador alfa (TGFα) estudados em amostras no Rio de Janeiro, Curitiba e turca (Istambul) (objetivo-IV). As coletas de dados do presente estudo foram realizadas em duas etapas: clínica e laboratorial. Os resultados encontrados foram: (I) uma alta heterogeneidade entre os estudos (Q = 52,81, p < 0.01, I2 = 98) com a prevalência final de HMI de 13.48% na população barasileira; (II) as intercorrências na gestação e o uso de medicamentos na primeira infância tiveram uma associação significativa com a presença de HMI (OR = 3,01; 95% CI = 1,74- 8,42; p= 0,014; OR = 3,55; 95% CI = 1,35-10,57; p = 0,019 ), entretanto esses fatores não influenciaram a gravidade dessa condição (p>0,05); (III) houve um resultado significativo no SNP rs2235091 localizado no gene KLK4 com a HMI (p<0,001), e os polimorfismos rs4694075 (AMBN) e rs3796704 (ENAM) mostraram associação com a cárie dentária (p<0.05); (IV) a amostra do Rio de Janeiro apresentou uma interação entre os SNPs rs1523305 (TGFα) e rs642961 (IRF6) (p = 0,03) e entre rs2073487 (IRF6) e rs2902345 (TGFα) (p = 0,04). Além disso, no estudo de Istambul houve uma associação entre o SNP rs930655 (TGFα) com todos os marcadores do gene IRF6 (p<0,05). Em relação ao uso de medicamentos nos primeiros anos de vida houve uma associação com os genes TGFα e IRF6 nas amostras de Curitiba e do Rio de Janeiro (p<0,05). Conclui-se que; (I) a prevalência de HMI é de 13.48% na população brasileira; (II) existe uma relação entre a presença de HMI com complicações que ocorrem durante a gestação (uso de medicamentos) e nos primeiros anos de vida da criança, entretanto esse fatores não influenciaram na gravidade dessa condição; (III) os genes que atuam na formação do esmalte são capazes de influenciar tanto no desenvolvimento da HMI como podem estar associados à cárie dentária e (IV) os polimorfismos localizados nos genes IRF6 e TGFα estão relacionados com o desenvolvimento da HMI. Além disso, o uso de medicamentos nos primeiros anos de vida podem potencializar o desenvolvimento da HMI. (AU)

It is a thesis composed of four studies, with the main to evaluate possible etiological factors (environmental and genetic variation) associated with the presence of MIH in the Brazilian population through (e); (objective-I); a cross-sectional observational study, with a bibliographic review of the prevalence of MIH in Brazil (objective-I); to determine of environmental factors (during in the pregany period and childhood) associated with the presence of MIH, and to evaluate the influence of these factors with the MIH severity (objective-II); associations of single nucleotide polymorphism (SNPs) presentin the genes ameloblastin (AMBN), enamelin (ENAM) and kalekrein (KLK-4) with MIH, in addition to the possible susceptibility of this genes to dental caries (objective-III); and interaction of environmetal factors and to determine the influence of genes interferon regulatory factor 6 (IRF6) and transforming growth factor alpha (TGFα) with MIH in a Brazilian (Rio de Janeiro e Curitiba) and Turkish (Istanbul) population (objective-IV). Data collections of the present study were carried out in two stages: clinical and laboratory.The results found were: (I) a high heterogeneity among the studies (Q = 52.81, p<0.01, I2 = 98) with a final prevalence of 13.48% na Brazilian population; (II) an association between intercurrences during pregnancy and child taking medications with the presence of MIH (OR = 3.55; 95% C.I = 1.35-10.57, p= 0.014; OR = 3.01; 95% C.I = 1.74- 8.42, p= 0.019, respectively), however these factors did not influence the severity of MIH (p>0.05); (III) there was an association between the variant alleles of polymorphisms rs2235091 in the KLK4 gene (p≤0.01) with the presence of MIH and the SNPs rs4694075 in AMBN and rs3796704 in ENAM presents association with dental caries (p<0.05); (IV) that the study from Rio de Janeiro showed a statistical evidence of interaction between TGFA rs1523305 and IRF6 rs642961 (p=0.03) and between genes IRF6 rs2073487 and TGFA rs2902345 (p=0.04). Significant results were found for the study from Istanbul between TGFα rs930655 and all IRF6 markers (p<0.05). Also, there was found statistical evidence for interaction of the SNPs in IRF6 and TGFα genes and medication taking from Curitiba and Rio de Janeiro studies (p<0.05). In summary; (I) the prevalence of MIH is 13.48% in the Brazilian population; (II) there is a relationship between complication that occur during pregnancy and in the child's first years of life with the presence of MIH, however these factors do not influence the severity of this condition; (III) the genes that acting in the enamel formation may influence the development of MIH and them, may be associated with dental caries; (IV) the polymorphisms located in the IRF6 and TGFα genes play a role in the development of MIH in different populations and that these genes may interacting with the medication taken in the first years of life, pontecialising the presence of MIH. (AU)

Microcephaly/Trigonocephaly, Intellectual Disability, Autism Spectrum Disorder, and Atypical Dysmorphic Features in a Boy with Xp22.31 Duplication.

The Xp22.31 segment of the short arm of the human X chromosome is a region of high instability with frequent rearrangement. The duplication of this region has been found in healthy people as well as in individuals with varying degrees of neurological impairment. The incidence has been reported in a range of 0.4-0.44% of the patients with neurological impairment. Moreover, there is evidence that Xp22.31 duplication may cause a common phenotype including developmental delay, intellectual disability, feeding difficulty, autistic spectrum disorders, hypotonia, seizures, and talipes. We report on a patient with microcephaly and trigonocephaly, moderate intellectual disability, speech and language delay, and poor social interaction in addition to minor but atypical dysmorphic features. This report provides further insight into the pathogenicity of the Xp22.31 duplication by extending knowledge of its clinical features. This case, in association with those reported in the literature, indicates that the Xp22.31 duplication may contribute to cause pathological phenotypes with minor facial dysmorphisms, microcephaly, and intellectual disability as main features.

Prevalence of dental developmental anomalies of permanent teeth in children and their influence on esthetics.

OBJECTIVE: The aim of this study was to determine the prevalence of dental developmental anomalies in permanent teeth and their influence on esthetics. MATERIALS AND METHODS: The records of 473 subjects, which comprised of orthopantomograms, clinical examination, and anamnestic data, were explored for dental developmental anomalies. Subjects with dental anomalies completed the modified questionnaire. Data on reasons for seeking the treatment as well as factors affecting the patients' satisfaction were collected. The data were processed using the Chi-square test. RESULTS: It was found that 79 subjects (16.7%) had at least 1 dental developmental anomaly. The most common anomalies were hypodontia (7.2%), followed by talon cusps (3.4%), and microdontia (2.5%). Hypodontia, microdontia, and talon cusps were found more prevalent in females than males, whereas hyperdontia and macrodontia were more common in males. The reason for dissatisfaction with their smile in most cases was due to missing teeth or spacing between anterior teeth (excess space 2.9 mm ± 1.1 mm), followed by crowding of anterior teeth (lack of space 3.1 mm ± 0.8mm), difficulty maintaining oral hygiene and midline asymmetry (1.8 mm ± 0.9 mm). All subjects were treated using a fixed orthodontic appliance and 30 (37.9%) of them had additional dental specialists included to achieve good esthetics and function. Overall, 92.4% of subjects were satisfied with their resulting appearance after treatment. CONCLUSIONS: Dental developmental anomalies are clinically evident abnormalities. They may be the cause of various dental problems and can influence esthetics and the development of orthodontic problems. CLINICAL SIGNIFICANCE: This paper evaluates the distribution of dental developmental anomalies and their influence on esthetics and function. Careful observation and appropriate investigation are required to diagnose the condition and institute treatment. The therapeutic approach to some dental anomalies should be interdisciplinary.

Dental anomalies: prevalence and associations between them in a large sample of non-orthodontic subjects, a cross-sectional study.

BACKGROUND: To analyze the prevalence and associations between dental anomalies detectable on panoramic radiographs in a sample of non-orthodontic growing subjects. METHODS: For this cross-sectional study, digital panoramic radiographs of 5005 subjects were initially screened from a single radiographic center in Rome. Inclusion criteria were: subjects who were aged 8-12 years, Caucasian, and had good diagnostic quality radiographs. Syndromic subjects, those with craniofacial malformation, or orthodontic patients were excluded and this led to a sample of 4706 subjects [mean (SD) age = 9.6 (1.2) years, 2366 males and 2340 females]. Sample was subsequently divided into four subgroups (8, 9, 10, and 11-12 year-old groups). Two operators examined panoramic radiographs to observe the presence of common dental anomalies. The prevalence and associations between dental anomalies were also investigated. RESULTS: The overall prevalence of dental anomalies was 20.9%. Approximately, 17.9% showed only one anomaly, 2.7% two anomalies, while only 0.3% had more than two anomalies. The most frequent anomalies were the displacement of maxillary canine (7.5%), hypodontia (7.1%), impacted teeth (3.9%), tooth ankylosis (2.8%), and tooth transposition (1.4%). The lower right second premolar was the most frequent missing teeth; 3.7% had only one tooth agenesis, and 0.08% had six or more missing tooth (Oligodontia). Mesiodens was the most common type of supernumerary tooth (0.66%). Two subjects had taurodontic tooth (0.04%). Tooth transpositions and displacement of maxillary canine were seen in 1.4 and 7.5%, retrospectively (approximately 69 and 58% were in the 8 and 9 year-old groups, retrospectively). Significant associations were detected between the different dental anomalies (P < .05). CONCLUSIONS: The results of our study revealed significant associations among different dental anomalies and provide further evidences to support common etiological factors.

Prevalence of Dental Anomalies in Permanent Dentition of Brazilian Individuals with Down Syndrome.

OBJECTIVE: The aim of this study was to evaluate the incidence of dental anomalies in the permanent dentition of individuals with Down Syndrome (DS) to increase the knowledge on the dental issues in this syndrome. METHOD: One hundred and five panoramic X-rays of patients with DS (61 males and 44 females), aged 7 to 42 years were used. The data were statistically analyzed using bivariate analyses test (p <0.05). RESULTS: Dental anomalies were observed in 50.47% of the sample. More than one anomaly was observed in 9.52% of the individuals. The most frequent dental anomalies were hypodontia and microdontia (16.19%), followed by retained tooth (10.47%), taurodontism (9.52%), supernumerary teeth (5.71%), macrodontia (2.85%) and root dilaceration (0.95%). There was no statistically significant difference between genders for any of the anomalies. CONCLUSION: A high prevalence of dental anomalies was observed in individuals with DS. The results of the present study reinforce the importance of good dental care, offering a greater basis for professionals who provide dental service to these patients.

Oral Findings and Dental Treatment in a Child with Williams-Beuren Syndrome

Williams-Beuren syndrome (WBS), also known as Williams syndrome, is a rare congenital disorder involving cardiovascular problems, mental retardation, distinctive facial features and tooth anomalies. It is caused by the submicroscopic deletion of 1.5 to 1.8 Mb on chromosome 7q11.23. This paper reports the dental care to a 7-year-old child with WBS syndrome. The interview also revealed visual impairment, sensorineural hearing loss, hyperacusis, photophobia and hoarse voice. The intraoral clinical examination showed anterior open bite, tongue thrusting, excessive interdental spacing, enamel hypomineralization of the incisors, hypoplasia and caries lesions. The dental treatment included: modulating sessions to control aversion to noises, the photophobia, and the dental fear and anxiety because of his reduced visual acuity; oral hygiene instructions, dietary and daily use of a 0.05% sodium fluoride mouthwash; the permanent mandibular left first molar was treated endodontically, and maxillary and mandibular first molars were restored with amalgam. Due to the patient's heart defect, a prophylactic antibiotic regimen was prescribed prior to the dental procedures. This patient has been followed up for 4 years and this case report underscores the importance of early dental evaluation and counseling for parents of WBS patients.

A Síndrome de Williams-Beuren (SWB), também conhecida como síndrome de Williams, consiste em uma desordem congêntica rara a qual apresenta problemas cardiovasculares, retardo mental, alterações faciais e anomalias dentárias. É causada pela microdeleção de 1,5 a 1,8 Mb no cromossomo 7q11.23. Este trabalho relata o tratamento odontológico de uma criança de 7 anos com a síndrome. Durante a anamnese constatou-se deficiência visual, perda auditiva neurossensorial, hiperacusia, fotofobia e voz rouca. O exame clínico intra-oral revelou mordida aberta anterior, deglutição atípica, espaçamento interdental excessivo, hipomineralização dos incisivos, hipoplasia e lesões de cárie. O tratamento dentário incluiu: sessões de condicionamento comportamental afim de controlar a aversão a ruídos, a fotofobia e o medo e a ansiedade frente ao tratamento odontológico, provocadas principalmente por sua reduzida acuidade visual; instruções de higiene oral, dieta e uso diário de bochechos de fluoreto de sódio a 0,05%; endodontia do primeiro molar permanente inferior esquerdo e restaurações de amálgama nos primeiros molares superiores e inferiores. Devido ao defeito cardíaco do paciente, antibioticoterapia profilática foi realizada antes dos atendimentos odontológicos. Este paciente está em acompanhamento há 4 anos e este relato ressalta a importância da avaliação odontológica precoce e do aconselhamento aos pais dos pacientes com SWB.

Reabilitação oral de paciente portador de displasia ectodérmica anidrótica / Oral rehabilitation of a patient with anhidrotic ectodermal dysplasia

O presente trabalho teve como objetivo relatar um caso de reabilitação bucal de um paciente portador de displasia ectodérmica, através de próteses totais fixas aparafusadas sustentadas por implantes zigomáticos e convencionais. Os aspectos clínicos e radiográficos serão descritos juntamente com a sequência de tratamento realizada até a finalização do caso. Esse tipo de tratamento tem apresentado resultados satisfatórios.

This case reports on the use of total fixed implant-supported screwed prostheses with zygomatic and conventional implants in the treatment of a completely edentulous patient with anihidrotic ectodermal dysplasia. Clinical and radiographic aspects are demonstrated during treatment sequence. This kind of rehabilitation has presented satisfactory results.

Carillas de composite como alternativa a carillas cerámicas en el tratamiento de anomalías dentarias: reporte de un caso / Composite veneers as an alternative to ceramic veneers in the treatment of dental anomalies: case report

Las anomalías dentarias de forma y tamaño son alteraciones anatómicas frecuentes que comprometen la estética del sector anterior. Existen distintos abordajes para tratar esta alteración morfológica. El procedimiento con mayor demanda es la restauración con carillas estéticas, cuyos materiales de elección son la cerámica en el caso de restauraciones indirectas y resinas compuestas en el caso de las restauraciones directas. La cerámica conserva propiedades físicas y estéticas que la convierten en la primera opción; sin embargo, las resinas compuestas se convirtieron en una alternativa confiable. Se presenta a consulta paciente con inconformidad estética. Al examen intraoral se observan órganos dentarios 12 y 22 en forma de espiga, se observan diastemas en el maxilar superior, sector anterior. Se propuso como plan de tratamiento la restauración estética del sector anterosuperior con carillas en resina compuesta empleando preformas plásticas. El objetivo del presente caso es la descripción del tratamiento restaurador estético realizado con resinas compuestas, empleando cofias preformadas.

The tooth anomalies of size and shape are common anatomical alterations involving the aesthetics of the anterior sector. There are different approaches to address this morphological alteration. The procedure most in demand is restoration with veneers, with the materials of choice in this case being indirect ceramic restorations and direct composite resin restorations. The ceramic preserves physical and aesthetic properties that make it the first choice, but composite resins are becoming a reliable alternative. The case of a patient is presented who consulted with aesthetic anomalies. In the intraoral examination 2 pin-shaped dental organs 12 and 22 are observed, as well as diastemas in the maxilla, in the anterior sector. A proposed treatment plan was cosmetic restoration of anterior-superior sector with composite resin veneers using plastic preforms. The aim of the present case is to describe the aesthetic restorative treatment performed using composite resin copings.