Facetas em resina composta com fechamento de diastemas para harmonização do sorriso: relato de caso / Composite resin veneers with diastema closure for smile harmonization: A case report / Facetas de resina compuesta con cierre de diastemas para harmonización de la sonrisa: Informe de caso

Introdução:A estética do sorriso é um aspecto valorizado pela sociedade atual, o que demanda que os profissionais de odontologia estejam atualizados sobre materiais dentários e novas técnicas para alcançar resultados estéticos restauradores de alta qualidade. A resina composta é frequentemente utilizada para simplificar a reabilitação oral, pois oferece facetas dentárias que combinam excelente estética e durabilidade. Objetivo:Este artigo tem como objetivo relatar um caso clínico de reabilitação estética utilizando facetas em resina composta com fechamento de diastemas.Relato de caso:Uma paciente do sexo feminino, com 24 anos de idade, procurou a clínica escola de odontologia com insatisfação em relação à estética do seu sorriso. A pacienteapresentava diastemas, restauração defeituosa e desproporção no tamanho dos dentes anteriores. O tratamento consistiu em um clareamento caseiro prévio, seguido pela confecção de facetas diretas em resina composta para fechamento dos diastemas e correção da desproporção dentária. Foram utilizados um Jig Estético e o software Digital Smile Design (DSD)para o planejamento, além de um mock-up em resina bisacrílica. Após a confecção das facetas, foi obtido um resultado estético final satisfatório. O caso incluiu um total de oito facetas,dos dentes 14 ao 24. Conclusão:O tratamento utilizando restaurações em resina composta proporcionou à paciente uma reabilitação estética, funcional e biológica (AU).

Introduction:Smile aesthetics is an aspect valued by today's society, which demands that dental professionals are up to date on dental materials and new techniques to achieve high-quality restorative aesthetic results. Composite resin is often used to simplify oral rehabilitation, as it offers dental veneers which combine excellent aesthetics and durability. Objective:This article aims to report a clinical case of aesthetic rehabilitation using composite resin veneers with diastema closure. Case report:A24-year-old female patient came to the dental school clinic with dissatisfaction regarding the aesthetics of her smile. The patient had diastemas, defective restoration and disproportionate anterior teeth size. The treatment consisted of prior at-home tooth bleaching, followed by creating direct composite resin veneers to close the diastemas and correct tooth disproportion. An Aesthetic Jig and the Digital Smile Design (DSD) software program were used for planning, in addition to a mock-up in bisacrylic resin. After treatment, a satisfactory final aesthetic result was obtained. The case included a total of eight veneers, from teeth 14 to 24. Conclusion:Treatment using composite resin restorations provided the patient with aesthetic, functional and biological rehabilitation (AU).

Introducción: La estética de la sonrisa es un aspecto valorado por la sociedad actual, hecho que demanda de los profesionales de odontología actualización constante sobre los materiales dentarios y nuevas técnicas para alcanzar resultados estéticos restauradores de altacualidad. La resina compuesta es frecuentemente utilizada para simplificar la rehabilitación oral, pues ofrece facetas dentarias que combinan excelente estética y durabilidad.Objetivo: Este artículo tiene como objetivo relatar un caso clínico de rehabilitación estética a partir de la utilización de facetas en resina compuesta con cierre de diastemas. Informe de caso: Una paciente, del sexo femenino, con 24 años de edad, buscó la clínica-escuela de odontología insatisfecha con la estética de su sonrisa. La paciente presentaba diastemas, restauración dentaria defectuosa y desproporción en el tamaño de los dientes anteriores. El tratamiento consistió en un blanqueamiento casero previo, seguido por la confección de facetas directas de resina compuesta para cierre de los diastemas y corrección de la desproporción dentaria. Fueron utilizados un Jig Estético y el software Digital Smile Design(DSD) para el planeamiento, además de un mock-upen resina bisacrílica. Tras la confección de las facetas, fue obtenido un resultado estético final satisfactorio. El caso incluyó un total de ocho facetas, de los dientes 14 al 24.Conclusión: El tratamiento a partir de restauraciones en resina compuesta proporcionó a la paciente una rehabilitación estética, funcional y biológica (AU).

'M' mechanics for midline diastema correction in mixed dentition.

Maxillary midline diastema is a self-correcting anomaly which in few conditions may get retained in adolescence stage due to various aetiological factors and correction of which is usually done at permanent dentition stage. The persistence of midline diastema can be predicted in mixed dentition period and necessary management could be provided at the mixed dentition period. This case report is on a novel technique using 'M' spring to correct the midline diastema in mixed dentition period.

The relationship between different levels of facial attractiveness and malocclusion perception: an eye tracking and survey study.

INTRODUCTION: The aim of this study was to investigate the relationship between levels of facial attractiveness and the perception of different types of malocclusion. METHODS: A preliminary questionnaire was used to assign photographs of three female patients to low, moderate, and high facial attractiveness designations. Seven modified photographs for each smile photograph of each of these three patients were created. The evaluated photographs were as follows: P0: at rest position, P1: ideal smile, P2: - 2-mm (low) smile line, P3: + 4-mm gummy smile, P4: + 6-mm gummy smile, P5: maxillary anterior crowding, P6: median diastema, P7: polydiastema. An eye tracking device and a questionnaire were used to collect data from orthodontists, dentists, orthodontic patients, and laypeople. RESULTS: Total fixation duration varied depending on the type of malocclusion, the level of facial attraction, and the participants' occupations. In general, orthodontists and dentists had higher total fixation duration scores than orthodontic patients and laypersons. The maxillary anterior crowding photograph had the lowest visual analysis scale score at each attractiveness level (low, medium, and high). Visual analysis scale scores became similar at each attractiveness level only in the P4 photographs, and thus the difference in facial attractiveness disappeared. CONCLUSION: While a worsening of the ideal smile had a smaller impact on aesthetic perceptions in an individual with low facial attractiveness, it had a significant negative impact on a person with high facial attractiveness. Anterior crowding and diastema had a more negative impact on facial attractiveness than low or high smile lines.

Direct vs indirect restorations for diastema closure: determining the suitable approach.

Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treatment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisal wear, and severe dentogingival disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures.

Comparison of pleasant and unpleasant smile characteristics in the perception of the laypeople in an Iranian population.

INTRODUCTION: This study aimed to compare the characteristics of pleasant and unpleasant smiles from the perception of laypeople. METHODS: Two-hundred posed smile photographs were obtained from adult participants with no anomaly, restoration, or severe crowding and spacing in anterior teeth. Photographs were shown to 26 judges to give each photograph a score for attractiveness. Upper and lower quartiles for the most and least rated smiles were determined, and variables including gingival display, smile arc, midline deviation, buccal corridor, smile width, tooth rotation or malposition, diastema, upper and lower vermilion show, and tooth form were measured. Independent-sample t test and Pearson chi-square analysis were used to determine the differences between the pleasant and unpleasant groups for quantitative and qualitative variables, respectively. The linear regression model revealed variables with the most significant impact on the mean score. RESULTS: All quantitative and qualitative variables except tooth form significantly differed between pleasant and unpleasant smile groups (P <0.05). The consonant smile arc was associated with an increase of 12.59% in mean scores compared with the inconsonant smile arc. Each tooth reported with malposition was correlated with a decrease of 9.37% in the scores. In the same way, each 1-mm increase in midline diastema and occlusal cant coincided with a drop of 8.73% and 3.59% in scores, respectively. CONCLUSIONS: The results of this study suggested that smile arc, tooth malposition, midline diastema, and occlusal plane canting had the most impact on smile esthetics and should be given priority by orthodontists in the treatment plan of choice.

The Effect of Ground and Unground Enamel on the Clinical Performance of Direct Composite Build-up After Orthodontic Treatment: Five Years of Follow-up.

PURPOSE: To assess the clinical performance of restorations with ground and unground enamel for diastema closure. METHODS AND MATERIALS: Twenty-four patients attended and received two to ten composite build-ups for diastema closure. The restorations were performed separately by grinding and not grinding the enamel on the proximal surfaces on symmetric teeth. A nanofill direct composite (Filtek Ultimate Universal Restorative System, 3M ESPE, St Paul, MN, USA) was used with a three-step etch-and-rinse adhesive (Scotchbond Multi-Purpose, 3M ESPE) for restorations. Restorations were evaluated according to the modified United States Public Health Service (USPHS) criteria at baseline and 1-, 2-, 3-, 4-, and 5-year recalls. RESULTS: The cumulative success rate of direct composite build-up with ground and unground enamel was 100% and 88.7%, respectively. Six restorations with unground enamel failed due to fracture. No significant difference was found between the restorations with ground enamel and unground enamel with regard to the evaluation criteria. CONCLUSION: The 5-year success rates of restorations with ground and unground enamel were excellent. The success rate of restorations with ground enamel was higher than that of restorations with unground enamel. Fracture was the reason for failure in the restorations with unground enamel.

Sleep-Disordered Breathing and Its Potential Impact on Restorative Dentistry: A 14-Year Case Study.

Understanding the effects sleep-disordered breathing can have on dentitions may be critical to the long-term success of restorative treatment. In the current case, a patient presented with a large diastema that was successfully closed using porcelain veneers only to have an unexpected unesthetic consequence occur years later. The case demonstrates that if the clinical focus is solely on reparatory modalities or clinical management, without recognition of possible airway issues, unintended restorative consequences may surface in the future. Studying and understanding the origin of the signs and symptoms of sleep-disordered breathing can be crucial for the prevention of future problems and optimization of a patient's overall health.

Maxillary midline diastema closure with sectional feldspathic porcelain veneers: A case series followed 1 to 4 years.

OBJECTIVE: To evaluate clinical outcome of maxillary midline diastema closure using sectional feldspathic porcelain veneers up to 4 years. MATERIALS AND METHODS: Five female patients with stable maxillary midline diastema were included in the current study and restored with minimal invasive sectional feldspathic porcelain veneers under dental microscope. Esthetic, functional, as well as biologic properties of sectional veneers were evaluated according to the World Dental Federation (FDI) criteria after 1 to 4 years' follow-up. RESULTS: Based on FDI criteria, all five cases were evaluated as clinically excellent to satisfactory during a mean observation period of 26.4 months. Slight to moderate cervical marginal staining was observed in two cases after 3 to 4 years' follow-up. Slight white line or ditching of labial surface margin was found in most cases, but it is not easy to be noticed with saliva covering the margins. CONCLUSIONS: Sectional feldspathic porcelain veneers presented satisfying clinical outcome with potential long-term esthetic risk for maxillary midline diastema closure. CLINICAL SIGNIFICANCE: 1. Sectional feldspathic porcelain veneers presented satisfying short to medium term clinical performance when applied to close maxillary midline diastema. 2. The exposure of labial surface margin may increase a long-term potential esthetic risk.

Gingival Conditioning with Provisional Composite Veneer Prior to Final Dental Restoration: Three-year Follow-up.

This manuscript reports a three-year follow-up of a case of gingival conditioning with a provisional composite veneer prior to diastema closure and tooth recontouring with direct composites. This conservative treatment resulted in a natural and harmonious smile.

Associations among the occurrence or types of maxillary canine impaction, labial frenum attachment types, lateral incisor anomalies, and midline diastema in patients with and without impaction: A case-control study.

INTRODUCTION: We tested whether the labial frenum attachment types may affect the occurrence or type of maxillary canine impaction. METHODS: This case-control study was performed on 96 subjects (48 with maxillary canine impaction [20.50±4.99 years, 32 females], 48 controls [21.94±3.79, 31 females]). Types of canine impaction (buccal/palatal, bilateral/unilateral, left/right), types of upper lip middle frenums (mucosal, gingival, papillary), the anatomy of lateral incisors (impacted, peg shaped, small, normal), and the midline diastema were evaluated clinically and radiographically. Associations were examined using multiple binary logistic regression, 3-way repeated-measures ANCOVA, and Fisher tests (α=0.05, ß=0.2). RESULTS: The numbers of mucosal, gingival, and papillary frenums in the case group were '29, 14, and 5', respectively; in the control group, they were '25, 21, and 2' (Fisher, P=0.248). The numbers of mucosal, gingival, and papillary frenums were respectively '25, 11, and 1' in the palatally impacted canine subgroup; they were '4, 3, and 4' in the buccally impacted subgroup (Fisher, P=0.010). Abnormal laterals were present in 12 cases and 4 controls; normal laterals were observed in 36 cases and 44 controls (Fisher, P=0.053). Abnormal laterals were seen in 10 cases with palatally impacted canines and 2 cases with buccally impacted canines; normal laterals existed in 27 cases with palatally impacted canines and 9 cases with buccally impacted canines (Fisher, P=0.705). Lateral anatomy was not associated with frenum attachment (Fisher, P=0.827). Greater midline diastemas were seen in cases with maxillary canine impaction, papillary frenums, and abnormal laterals (ANCOVA, P≤0.016). CONCLUSIONS: Buccal type of canine impaction is positively associated with papillary labial frenums. Canine impaction is 3.6 folds more prevalent in cases with lateral abnormality. Midline diastema is positively and independently associated with canine impaction, papillary frenums, and abnormal laterals.

Should midline diastema in mixed dentition be an aesthetic concern?

BACKGROUND: Mixed dentition determines an important period of occlusion development in childhood. OBJECTIVE: This study aimed to evaluate the aesthetic impact of the midline diastema cut-off point in mixed dentition. DESIGN: A cross-sectional study was performed with 257 children aged 8-10 years in late mixed dentition, with midline diastema of 1-5 mm and normal maxillary overjet. Orthodontic Aesthetic Subjective Impact Score determined the aesthetic impact of the midline diastema. Four quartiles of diastema measurements and impact scores were considered as cut-off points. Receiver Operating Characteristic curves were constructed, and the distances representing the distances to the ideal point were calculated. The Yuden index determined the efficiency of measuring the diastema to assess the aesthetic impact. The Kruskal-Wallis test compared the groups of participants classified according to the diastema cut-off by the sample quartile regarding the impact score. The analyses were performed with a significance level of 5%. RESULTS: There was no significant difference between the four groups of measurement quartiles of the diastema regarding the aesthetic impact (P > .05). CONCLUSIONS: The perception of dental aesthetics in mixed dentition children was not affected by the midline diastema, regardless of the cut-off point.

Maxillary Midline Diastemas in West African Smiles.

The maxillary midline diastema (MMD) has experienced a renaissance in popular culture over the last 10 years. Current literature states that MMDs should be eliminated where possible or be reduced to 1 mm or less in width. This literature review explores the evidence for this in a West African population. A systematic search of the literature (Medline and Google Scholar) followed by a hand search was carried out to identify all papers evaluating perceptions of MMDs. In all, 209 papers were identified in the literature search, 8 of which met the inclusion criteria. The review revealed that midline diastemas are desirable in this specific population with a width of 2 to 4 mm deemed as attractive. As many as 95% of participants found the MMD beautiful, and as many as 95% would consider having one created artificially. The literature does not support the position that MMDs larger than 1 mm should always be treated to be perceived as attractive in this population. MMDs are accepted as attractive and should be considered a key feature in smile design for this population.

Two-year retrospective evaluation of monoshade universal composites in direct veneer and diastema closure restorations.

OBJECTIVES: The aim of this retrospective evaluation was to assess the short-term outcome of two monoshade universal resin composites with high chameleon effect in anterior direct veneer and diastema closure restorations, and to investigate the possible reasons for failure. MATERIAL AND METHODS: Patients subjected to veneer and diastema closure restorations with two monoshade universal resin composites (Essentia Universal Shade; EU, GC Corp., and Omnichroma; OC, Tokuyama) operated between January 2018 and March 2019 were selected for the present retrospective evaluation. A total of 159 composite restorations (78 veneers and 81 diastema closure restorations) performed by a single operator in 44 patients (mean age: 33.6) were included in the study. Two blinded and calibrated examiners performed 1- and 2-year assessments of the restorations with respect to FDI criteria, using medical/clinical history and dental photography records. Data were analyzed using Pearson Chi-square with Continuity Correction, Fisher's Exact tests, and Cox regression (a < 0.05). RESULTS: The cumulative overall survival rates of EU and OC restorations were 94.6% (97.3% for the first year) and 88.6% (95.3% for the first year), respectively, with no significant difference from each other (p = 0.316). The cumulative overall survival rates of direct veneer and diastema closure restoration types were 90.2% (95.1% for the first year) and 92.4% (97.4% for the first year), respectively, with no significant difference (p = 0.559). The reasons for failure were evaluated as fracture of the restoration, failure in esthetic anatomical form, and color mismatch. All the failed direct veneer restorations were due to fractures (FDI score of 5.4), whereas 5 of 6 failed diastema closure restorations were due to color mismatch (FDI score of 3.4). Regarding the composite materials, there were no significant differences between the success rates of the restoration types (p = 0.442 for EU, p = 1.000 for OC). With respect to the restoration types, there were also no significant differences between the success rates of the resin-based composites (p = 1.000 for direct veneer restorations and p = 0.228 for the diastema closure restorations). In addition, no significant difference was observed between male and female patients regarding the acceptable and unacceptable scores (p = 1.000). CONCLUSIONS: The 2-year clinical performance of the two monoshade universal composites in anterior veneer and diastema closure restorations were both considered successful and similar. Despite the lack of shade selection, both monoshade universal composites presented a successful color match. However, the diastema closure restorations might be more prone to color mismatch compared to the veneers over time, while veneer restorations presented more fractures than the diastema closure restorations. CLINICAL SIGNIFICANCE: Monoshade universal composites presented successful short-term clinical outcomes regarding both function and esthetics in anterior direct veneer and diastema closure restorations.

An alternative approach for the surgical correction of unilateral crossbite.

This case report aims to describe a modified surgically assisted rapid palatal expansion technique to treat an asymmetrical posterior crossbite with no mandibular shift without causing an interincisal diastema. A clinical patient with an asymmetrical crossbite, large tooth-size-arch length, and Bolton discrepancy is used to illustrate the modified technique. Instead of traditional osteotomies, in this technique, the osteotomy is done between the maxillary right canine and lateral incisor (connecting the piriform aperture to the alveolar process) along with a unilateral LeFort I osteotomy. The expansion forces are produced by the activation of a conventional hyrax appliance. The skeletal unilateral crossbite was corrected without major changes to the opposite side and without causing an anesthetic diastema between the maxillary central incisors. A mandibular incisor extraction produced the space needed to treat the tooth size-arch length and corrected the Bolton discrepancy. This allowed a successful treatment of the problems initially presented by the patient.

Digital technology for fluid resin injection to close anterior diastema after orthodontic treatment.

Anterior diastema and tooth defects are common clinical issues in restorative dentistry and are often restored by veneers or crowns based on the results of digital smile design and wax-up. Traditional direct resin restoration for closing a diastema is relatively minimally invasive but is time consuming and laborious, and shape control depends on experience. Digital technology can be used to design and transfer the shape of aesthetic restoration more accurately and quickly; thus, it could close anterior diastema and restore defects easily. According to the workflow, this technical process integrates virtual design and practical wax-up, transfers the designed restoration shape by templates, and injects through the preset channel after the template is in place. This clinical technique simplifies the clinical operation and saves clinical time, which can effectively improve the predictability and accuracy of the restoration and reduce technical sensitivity. This digital workflow provides a new technology for closing diastema quickly and effectively.

Ortodontia minimamente invasiva auxiliando a reabilitação estética dos incisivos superiores ­ relato de caso / Minimally invasive orthodontics can help aesthetic rehabilitation of the upper anterior teeth ­ a case report

Resumo Esse artigo descreve o tratamento de um diastema na região anterior da maxila utilizando uma abordagem multidisciplinar. Paciente do gênero feminino, 38 anos, procurou atendimento odontológico na Clínica Faculdade de Odontologia da Universidade Nove de Julho, com queixa estética devido ao diastema da linha média maxilar. Após exame clínico e tratamento periodontal, verificou-se a necessidade de alinhamento e nivelamento dos dentes anteriores. O excesso de papila gengival entre 11 e 21 foi submetido à exérese, e um aparelho ortodôntico fixo foi instalado em 12, 11, 21 e 22. Após três semanas, quando os dentes estavam posicionados em condições mais favoráveis, uma contenção Hawley foi adaptada para pequenas correções no sentido vestíbulo-lingual. Para a restauração dos dentes, foi feito um molde diagnóstico e enceramento para permitir a construção de uma matriz de silicone. Um compósito nano-híbrido e um micro-híbrido foram escolhidos e colocados seguindo a matriz de silicone ajustada ao lado palatino dos dentes. Após os procedimentos de acabamento e polimento, o resultado estético foi muito satisfatório tanto para o paciente quanto para a equipe odontológica. A relevância clínica desse caso indica que é possível treinar alunos de Graduação para alcançar o sucesso no tratamento de diastemas adversos da linha média em um curto período de tempo, com planejamento e interação entre diferentes especialidades odontológicas. (AU)

Abstract This manuscript described the treatment of anterior maxillary diastema using a multidisciplinary approach. A female patient, 38 years old, looked for dental treatment at the University Nove de Julho Dental School Clinic with an esthetic complaint due to maxillary midline diastema. After clinical examination and periodontal treatment, the necessity of alignment and leveling of the anterior teeth was verified. Excess of gingival papilla between 11 and 21 underwent exeresis and an orthodontic fixed appliance was installed in 12, 11, 21, and 22. After three weeks, when the teeth were positioned in a more favorable condition, a Hawley retainer was adapted for small corrections in buccolingual direction. For teeth restoration, a diagnostic cast and wax-up was made to allow the construction of a silicone matrix. A nanohybrid and a microhybrid composite were chosen and placed following the silicone matrix adjusted to the palatal side of the teeth. After finishing and polishing procedures, the esthetic result was very satisfactory for both the patient and the dental staff. The clinical relevance of this case indicates that it is possible to train undergraduate students to achieve success treating adverse midline diastema in a short period of time throw planning and interaction among different dental specialties (AU)

Effect of ceramic and resin cement type on color stability and translucency of ceramic laminate veneers for diastema closure: an in vitro study.

To investigate the effect of resin cements on the color stability and translucency of ceramic laminate veneers used for diastema closure. Sixty resin abutments were prepared for ceramic laminate veneers and divided into six groups according to the ceramic type (lithium disilicate, zirconia-reinforced lithium silicate, and translucent zirconia) and the cement type (Variolink Esthetic LC and RelyX Veneer). Color coordinates and translucency were analyzed after cementation and after soaking in the coffee solution. Differences in color and translucency were estimated, and results were statistically assessed (α = 0.05). Ceramic materials showed a significant impact on color changes after soaking in coffee within Variolink Esthetic groups. Translucent zirconia showed the highest color change, followed by zirconia reinforced lithium silicate and lithium disilicate. Ceramic materials showed a significant impact among the RelyX Veneer groups. A significant interaction in color changes was found between ceramic types and cement types after cementation, and after soaking in coffee was found. All groups showed a clinically acceptable difference in translucency parameters after soaking in coffee. The resin cement affects the color and translucency of ceramic laminate veneers used for diastema closure, and ceramic laminate veneers bonded with Variolink Esthetic LC resin cement are more translucent, while ceramic laminate veneers bonded with RelyX Veneer resin are more resistant to coffee staining. The lithium disilicate laminate veneer is more resistant to coffee staining than zirconia reinforced lithium silicate and translucent zirconia laminate veneers used for diastema closure.

Advances in diastema closure and tooth shape change using direct composite restorations: the Front Wing Technique.

Closing a diastema with a direct composite restoration still represents a real challenge for clinicians, mainly due to the need to create a correct contact point and emergence profile at the cervical level. The present article describes a novel anterior direct composite restoration technique for closing diastemata and changing tooth shape. The proposed technique, called the Front Wing Technique (FWT), does away with the use of the traditional wax-up and silicone index-based procedures. To date, there has been no effective way to transfer the anatomy modeled in the wax to the interproximal cervical area of anterior restorations every time these areas need to be corrected or restored. Therefore, the FWT provides a new approach to freehand model the emergence profile without gap formation. The cases in this article demonstrate the closure of maxillary and mandibular incisal diastemata, with the rationale behind each clinical step of the FWT described. This technique should be considered an alternative approach for the direct composite restoration of anterior teeth, saving chair time and cost.

Cierre de diastemas múltiples mediante el uso de resina universal Omnichroma. Reporte de caso clínico / Multiple diastema closure using Omnichroma universal resin. A case report

La presencia de los diastemas es una de las quejas estéticas más comunes entre los pacientes. La utilización de resinascompuestas es una buena opción estética y funcional para realizar restauraciones e implementar técnicasrestauradoras de forma mínimamente invasiva. La técnica de estratificación con resinas se introdujo en 1980 dando muy buenosresultadosenlaseleccióndecolor,perosiendoelprocedimientomáscomplejoyrequiriendograndeshabilidadestécnicasademás de un aumento de tiempo clínico. Los materiales de composite y técnicas restauradoras que ayudan al uso simplificado deprotocolos clínicos son muy procurados por los odontólogos para reducir el tiempo de trabajo en el sillón yminimizar la sensibilidad postoperatoria. Es porestos motivos,ademásde simplificar la toma de color,queTokuyamaDentaldesarrollólaresinaOmnichromaquedicetenerlahabilidaddecopiarelcolordelsustratodel diente remanente poco después de la fotopolimerización conocido como "Efecto Camaleón" utilizando un solo tono. El objetivode este artículo es el de describir detalladamente mediante un reporte de caso clínico el cierre de diastemas con laresinauniversal Omnichroma deTokuyama Dental.

The presence of diastemas is one of the most common aesthetic complaints among patients. The use of composite resins is a good aesthetic and functional option to perform restorations and implement restorative techniques in a minimally invasive way. The resin layering technique was introduced in 1980, giving very good results in color selection, but being the most complex procedure and requiring great technical skills in addition to an increase in clinical time. Composite materials and restorative techniquesthat aid in the simplified use of clinical protocols are highly sought after by dentists to reduce chair time and minimize post-operative sensitivity. It is for these reasons, in addition to simplifying shade taking, that Tokuyama Dental developed Omnichroma resin which claims to have the ability to copy the color of the remaining tooth substrate shortly after light curing known as the "Chameleon Effect" using a single shade. The objective of this article is to describe in detail, through a clinical case report, the closure of diastemas with Tokuyama Dental's Omnichroma universal resin.

Multidisciplinary approach for the closure of multiple diastemata with composite resin.

Morphologic anterior tooth alterations and diastemata between the anterior teeth are often considered a major esthetic problem. In most cases, the treatment of these conditions involves a multidisciplinary approach. Orthodontic treatment together with direct composite resin veneers are a viable option to close diastemata and alter tooth shape. The extent and etiology of the diastemata must be considered and properly evaluated for the treatment. The present article is a case report of a patient with multiple diastemata in the maxillary anterior teeth, dental crowding, and peg-shaped lateral incisors corrected with orthodontic treatment and direct composite resin veneers. Digital planning was the tool used to decide the tooth proportions before orthodontic treatment and to guide the diagnostic wax-up. An etch-and-rinse adhesive system was applied after etching. A polychromatic layering technique under rubber dam isolation was used for the composite resin veneer construction. Finishing and polishing procedures were achieved using polishing discs and abrasive materials. Direct composite resin is an alternative that allows predictability, esthetics, and the possibility of adjustments, resulting in patient satisfaction.