GAP Australasian-Dentist-Mar Apr 2019

Category 66 AustrAlAsiAn Dentist CASE DESCRIPTION A 17 year old female was a victim of an assault which resulted in the complex fractures of teeth 11 and 21. tooth 11 was treated endodontically and with a preformed stainless-steel post, and both central incisors were restored with di- rect composite resin restorations which demonstrated a commonly encountered compromised clinical outcome and poor optical inte- gration, manifested as a mismatch of translucency and value. the patient’s chief concern was that the appearance of the interim composite restorations was unsatisfactory, and that they looked dull and grey. the patient’s main objective was to improve the appearance of her smile and her teeth with new restorations. the decision was made to restore these teeth and the remaining upper anterior teeth with direct composite restorations. sDi Aura composite was chosen because of its unique optical characteristics and handling. Aura composite comes in a range of dentine shades of varying chromaticity. Mimicking natural dental substrates, the available shades are limited to the narrow spectral shade range of over 90% of natural teeth. in addition, the handling characteristics of the material are such that ease of use, and resistance to slumping, sticking and distortion are such that the complex stratified build-ups of severely broken-down teeth become achievable in a predictable and reproducible manner. Aura uniquely does not employ standard VitA shading system, yet does have its dentine and enamel shades characterised by tones of increasing chroma and the hue/tint of the dentine shades are restricted to the narrow band within the spectrum that most natural tooth shades correspond to (equivalent to VitA A shades). natural tooth substrates vary in chromaticity and translucency, depending on the depth and maturity of the structure. As teeth age, they increase in both translucency and chroma, whilst value decreases. One of the benefits of Aura is that various shades of dentine and enamel composite are available based on the stage of maturation of the natural tooth we are replicating. the dentine shades range from a DB shade (bleach white) through to a highly chromatic DC7. Conversely, enamel is virtually achromatic, yet modulates value of the underlying dentine to varying degrees based on its translucency. the 3 enamel shade options are available in graduated levels of translucency, mimicking young, mature and aged enamel. Dr Angelo Lazaris Direct composite restoration of fractured incisors Using innovative, natural shading system of SDI Aura composite to replicate natural tooth stratification By Dr Angelo Lazaris, BDs (Hons) university of sydney Msc (Aes)– Kings College london lInICal Figure 1: Pre-operative condition. Existing composite resin restorations are too translucent and low in value. Figure 2a: Isolation and initial palatal layering utilising silicon stents.