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Name: Audrey Hesse, France University: Denis Diderot Paris 7

Name: Audrey Hesse, France University: Denis Diderot Paris 7. Introduction to the case.

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Name: Audrey Hesse, France University: Denis Diderot Paris 7

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  1. Name: Audrey Hesse, France University: Denis Diderot Paris 7

  2. Introduction to the case The patient, aged 29 and a heavy soda drinker, presented with decay on 9 and 10, and abrasion and erosion of all teeth resulting in a loss of vertical dimension. Teeth 7 and 8 contained old unaesthetic composite restorations. However, all teeth reacted positively to vitality tests. After instructing the patient on better oral hygiene and dietary habits, a direct restoration of the anterior teeth using layering techniques to acheive a more aesthetic result was planned. Prosthetic restoration of the posterior area will be achieved afterwards.

  3. Step 1 Palatal view of the initial case: Tooth #10 presented with decay. Old unaesthetic composite restorations appeared on the distal aspect of #8 and on the mesial aspect of #7.

  4. Step 2 From the wax-up, a silicone guide was designed, allowing creation of the palatal and incisal aspects. By removing the guide, the palatal impression could be observed.

  5. Step 3 Shade A3.5 was selected from the Vita shade guide, corresponding to D3 dentin and E3 enamel on the Ceram-X™ duo shade guide.

  6. Step 4 A rubber dam was placed, followed by removal of decayed tissue and the old restorations. Diamond burs were used for the cavity preparations.

  7. Step 5 The Xeno™ III Self-etching Adhesive was applied, air thinned and light cured. The Ceram-X™D3 was placed on the silicone guide using an incremental technique.

  8. Step 6 The incisal edge was restored with Ceram-X™ E3. Light curing was achieved after removal of the silicone guide.

  9. Step 7 The buccal surface was restored using Ceram-X™ D3 followed by Ceram-X™E3. The proximal surface was then restored using a metallic matrix and wooden wedge.

  10. Step 8 After finishing with diamond burs, proximal edges were polished using a sandpaper strip. Final polishing was completed using Enhance® Finishing cups and Prisma® Gloss™ Polishing Paste.

  11. Before After No sensitivity was observed after treatment and the patient was satisfied. The complexity of this clinical case benefited from a simplified layering technique using Ceram-X™ in order to obtain a good aesthetic result.

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