Introduction to the case

1. Name : Munin Chaichalothorn Professor : Watcharaporn Kuphasuk University : Mahidol University, Thailand Foto A 23-year-old young lady with good oral hygiene and low caries risk had malformed maxillary lateral incisors caused by developmental defects. She was unsatisfied with her smile so she wanted to improve asthetics. Treatment plan : Restore the malformed teeth 12 and 22 with direct composite restoration using Ceram·XTM Duo System. Before After Introduction to the case A before picture is mandantory. Please insert here your picture . After picture is mandantory. Please insert here your picture. Final results provide good aesthetics and restore effective function. The patient is very delight with her beautiful smile. The patient presented with malformed teeth 12 and 22. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1 : Study model and wax-up Step 2 : Shade selection Step 3 : Etching and bonding Step 4 : Palatal shell forming Palatal shell was formed with enamel shade (E2) using the silicone key. After try-in the silicone key, Caulk® 34% Tooth Conditioner Gel was applied for 15 seconds and rinsed off. Then, the tooth was dried. XP BONDTM was applied, gentle blown and polymerized for 10 seconds. Alginate impression was taken for study models an adiagnostic waxing-up model was made to reproduce the desired final results. Asilicone putty key was fabricated and used as a template. After cleaning, enamel shade (E2) and dentin shade (D2) was determined by using Ceram·XTM Duo System shade guides. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 1-8 pictures are not mandantory. You are allowed to delete not used frames. Step 5 : Interproximal wall Step 6 : Layering technique Step 7 : Shaping and polishing Step 8 : Final result Shade E2 was applied on the tooth with celluloid strip asamatrix for shaping of interproximal wall. Dentin shade (D2) was used for dentin body and followed by E2 as enamel layer. Recontouring of line angles and buccal surface was performed with fine diamond burs and abrasive discs to match the natural contour of the tooth. Enhance® Finishing System was used as finisher and polisher followed by polishing with PoGo® Diamond Micro-Polisher. The completed restoration of tooth 22 reveals the harmonious integration of Ceram·XTM Duo System with existing tooth structures. Materials and methods Composite built-up of the malformed teeth was done using the silicone putty key fabricated from the diagnostic wax-up model. The enamel surface was treated with Caulk® 34% Tooth Conditioner Gel and bonded with XP BONDTM Universal Total-Etch Adhesive. The Ceram·XTM Duo System (shade E2 and D2) was used to perform aesthetic results and restore effective function by layering technique. Shaping and polishing were achieved with fine diamond burs, abrasive discs, Enhance® Finishing System and PoGo® Diamond Micro-Polisher. Discussion and conclusions Several techniques have been suggested for correction ofmalformed teeth. Direct composite restoration is one of these techniques with many advantages, e.g., less invasive and inexpensive. In my opinion, Ceram·XTM Duo System has perfect properties to correct my patient‘s problems with simple and convenient procedures. This system reveals superior colors and translucency. The direct composite restorations using Ceram·XTM Duo System result in high aesthetic outcomes with the harmonious integration of the material with existing tooth structures.