Rotated teeth can be straightened with composite restoration by adding to areas lingual to an ideal position and reducing tooth structure facial to an ideal position. Correct tooth dimension should be maintained for esthetics, however, teeth can be altered to visually appear smaller or larger. Restoration of rotated teeth is further complicated by crowding or diastemas. Space analysis by visualization, diagnostic wax ups, or measuring teeth and space is required to assure proper esthetic results.
When minimal or no tooth reduction is done no anesthetic is required. A diamond bur roughens the enamel surface for increased bond strength, then the teeth are etched following the instructions from the manufacturer.
Apply Cosmedent Complete Bonding Adhesive. Place 2 drops of COMPLETE Primer/Unfilled Resin (red cap) in a mixing well. Thoroughly coat prepared tooth with 2 successive coats. Gently air thin. Apply an additional coat, air thin and light cure for 20 seconds. Make sure all surfaces have a shiny appearance; if not, apply an additional coat, air dry, and light cure 20 seconds.
Renamel Composite (Microhybrid, Nano+ Plus or Microfill) is placed and cured building the tooth incrementally. When contacts to adjacent teeth are being formed to close spaces, a Full Contact Matrix Band can be placed and composite added. An opaque lingual wall of Renamel Microhybrid or Nano+ Plus to mask any darkness from the back of the mouth.
Mesial distal dimension is measured on the restored tooth and compared to the distal mesial dimension of the adjacent tooth and space. Adjustments are made to the restored tooth with burs or FlexiDiscs.
Final shaping and polishing is achieved with burs, FlexiDiscs, FlexiPoints, FlexiCups, and Enamelize with FlexiBuffs and Felt FlexiPoints.