CATEGORY 70 AUSTRALASIAN DENTIST Visit our booth #1065 Visit Amalgadent #1065 at ADX24 Sydney for exclusive show offers Footer Ads #102.indd 4 23/01/2024 2:10:14 PM CLINICAL Endodontic Retreatment After subsequent healing, the endodontist retreated both central incisors. A CBCT was taken after 6 months to confirm radiographic evidence that the periapical lesion had resolved (Fig 8). Fig 8. CBCT 6 month post endodontic retreatment shows resolution of the periapical radiolucency on 21. Fig 9. Restorative phase began after there was radiographic evidence of resolution of the periapical radiolucent lesion. A fibre post was used to retain the core. Care taken to bond under rubber dam isolation and prepare the post space leaving the maximum amount of tooth structure. Fig 10. Functional crown lengthening surgery resulted in enhanced central incisor width/length ratio. Fig 11. Patient after the completion of treatment. Harmony restored. (Endodontist: Dr David Barnard; Dental technician: Riccardo Borgonovo) Dr. Andrew See is an expert in Aesthetic Dentistry with over 20 years of dedicated experience. His qualifications include a Masters in Aesthetic Dentistry from the prestigious King’s College London and a Postgraduate Diploma in Dental Implantology. Dr See completed his Fellowship by primary and secondary examinations for The Royal Australasian College of Dental Surgeons (FRACDS). Dr. See’s commitment to excellence makes him a sought-after resource in the field of Aesthetic Dentistry. His commitment to education and innovation is evident through his key opinion leader role for 3M Australasia and contributions as a speaker for CPD sessions. Restorative Phase Restorative treatment involved placement of a fibre post to enhance the retention of the core material. Special attention was given to avoid unnecessary enlargement of the existing canal, aiming to preserve as much tooth structure as possible to protect the teeth from fracture. The post space was cleaned and free of gutta percha. The post prep space was completed leaving 4.0mm of gutta percha in place. The post size selection was based on the largest post that would achieve passive fit in the canal and modified accordingly. A 1.9mm RelyX Fibre post (3M) was cemented with RelyX Universal cement (3M) in a self-adhesive mode (Fig 9). A composite core was placed using Scotchbond Universal Plus (3M) and Filtek One Bulk Fill (3M) and the final crown preparations were carried out with a goal of achieving 1.5mm of circumferential ferrule. The polyether (3M Impregum) impression was taken using a double cord technique and the preparations were provisionalised with 3M Protemp 4 and Tempbond Clear (Kerr). Bonding The provisionals were removed and the definitive crowns were issued under rubber dam isolation. The preparations were microetched with 50mm Aluminium Oxide and the crowns were adhesively bonded with Scotchbond Universal Plus (3M) and RelyX Universal cement (3M). The occlusion was adjusted and finalised. Conclusion The final outcome enhanced the harmony in the patient’s smile by improving the proportions of the central incisors (Fig 10, 11). The integration of checklists and decision-making workflows, coupled with a patient-centered approach, plays a pivotal role in informed consent and meeting patient expectations. The article invites a holistic perspective in addressing short teeth and gummy smiles, offering a roadmap to navigate such scenarios. u For more resources and insights, visit www.drandrewsee.com or connect on social media: Instagram – @dr.andrewsee, YouTube – @dr.andrewsee, Email – andrew@drandrewsee.com For the full list of references, contact Australiasian Dentist on: gapmagazines@gmail.com
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