Restoring Central Incisors with Composite

Dr. Brian LeSage walks through the process of repairing the chipped incisal edges of #8 and #9.

First, Dr. LeSage examined both teeth and determined all the micro-esthetic details to consider before the restoration. He looked at the polychromatic nature of the teeth, the lacking of an incisal halo, and the maverick white zones and spots. He also assessed the luster and polish. The goal is to create balance and harmony in the central incisors by mirroring the restoration in #8 and #9.

He first addressed #8, isolating the tooth with Teflon tape. He then created a “starburst bevel,” adding varied depth, length, and volume to the enamel surface in the incisal. The first layer he added was Renamel® NANO™ Plus A2 as the dentin substitute. Nanofill is used as a base where strength and function are crucial. (Microfill is used later for high polish and low wear.)

Next, he added Creative Color® Opaquer — White with an explorer or endo file. The entire facial surface of the tooth was covered with a single layer of Renamel Microfill A1, then sculpted to a preliminary outline form.

The process was repeated for tooth #9, starting with the “starburst bevel” into the enamel. Renamel NANO™ Plus A1 was added again as the dentin substitute and the Creative Color Opaquer — White. Next, the Renamel Microfill A1 was added.

Both teeth were finished and polished with the FlexiDisc® system to create a seamless restoration with the appropriate polish and luster. First, the Coarse FlexiDisc (Gray) was used dry at 5,000 to 7,000 RPMs to create the incisal edge plane and three facial planes. Next, the Medium FlexiDisc (Blue) was used wet at 10,000 to 20,000 RPMs. He bends the disc at 90 degrees and runs it from restoration to tooth. He continued to establish 3 facial planes.

Dr. LeSage finished with the FlexiBuff® Disc and Enamelize® Polishing Paste. First, he used copious amounts of water and Enamelize, running the FlexiBuff at 10,000 to 12,000 RPMs. He followed with a final pass with the FlexiBuff and Enamelize dry to achieve a high polish.

The final results show harmony and balance in color and outline form.

About the AuthorDr. Brian LeSage

Dr. LeSage practices in Beverly Hills, CA and is the founder and director of UCLA Aesthetic Continuum as well as the founder and director of the Beverly Hills Institute of Dental Esthetics. He is an Accredited Fellow of the American Academy of Cosmetic Dentistry and presided as the AACD Fellowship Chair from 2004-2013. Dr. LeSage is also a Fellow Member of the American Academy of Esthetic Dentistry and the Pre-Clinical Director of CAD/CAM at the UCLA School of Dentistry.