This 50 year old gentleman presented with extensive generalized wear due to intrinsic and extrinsic attrition. Following orthodontic treatment to reposition the teeth and stabilize the occlusion, he was referred for Bioclear restorations. He expressed understandable concerns about the appearance of his teeth.
End of fixed orthodontics and following debond photos highlight the extensive occlusal wear across all teeth and the significant reduction in tooth length. Vitality tests confirmed positive results.
Minimal preparation and an additive treatment approach were deemed essential.
-
Smile at the end of fixed orthodontics
-
Upper anteriors with fixed orthodontics
-
Lower anteriors with fixed orthodontics
Post orthodontic, pre-restorative treatment photos
-
Smile following orthodontics debond
-
Upper anteriors following orthodontics debond
-
Upper occlusal view following orthodontic debond
-
Retracted view following orthodontic debond
-
Lower anteriors following orthodontic debond
-
Lower occlusal view following orthodontic debond
The lower arch restoration began with a rubber dam and biofilm removal using aluminum trihydroxide powder and Aquasol (Aquacare). Bioclear Black Triangle matrices were placed, and the Bioclear Injection Molding technique was applied to the first central incisor with 3M™ Scotchbond™ Universal Plus, warmed 3M™ Filtek™ Supreme Flowable, and 3M™ Filtek™ Supreme XTE (shade A2). The tooth was shaped and refined to the approximate correct height with diamonds and 3M™ Sof-Lex™ discs.
The process was repeated for the second central incisor using the delayed wedging technique for proper space closure.
-
Matrices in situ post Biofilm removal
-
Matrices and hip placement LL1 after shaping LR1
The process was repeated for the lateral incisors and canines.
The incisal levels were verified to ensure symmetry and accuracy.
-
After shaping LR1 + LL1
-
LR2 after injection over-moulding
-
Immediately after polishing lower 3-3
At the next visit, treatment for the lower premolars and molars followed a similar approach, utilizing molar matrices and injection overmolding to create a combination of direct onlay/overlay restorations.
Occlusal and incisal levels were checked to ensure symmetry and accuracy.
-
LL4 after injection over-moulding
-
Matrices in-situ LL7
-
Matrices in situ LL6 after shaping LL7
-
After injection over-moulding LL6
-
After shaping LL467
-
Retracted view after completing the lower arch
Treatment then focused on the upper arch, aiming to correct the proportions of the front teeth and establish an ideal occlusion with the lower arch.
A rubber dam was placed, and biofilm was removed using aluminum trihydroxide powder and Aquasol (Aquacare). Bioclear Black Triangle matrices were positioned on the first tooth. The Bioclear Injection Molding technique was applied to the first central incisor using 3M™ Scotchbond™ Universal Plus Adhesive, warmed 3M™ Filtek™ Supreme Flowable, and 3M™ Filtek™ Supreme XTE Universal composite (shade A2). The tooth was shaped and refined to the approximate correct height with diamonds and 3M™ Sof-Lex™ discs.
-
Rubber dam isolation
-
Black Triangle matrices in situ 11
-
After injection over-mould 11
The process was repeated for the second central incisor, utilizing the "delayed wedging" technique to ensure proper space closure before injection moulding.
After removing the rubber dam, the ICP occlusion and anterior guidance for the central incisors were established. A new rubber dam was placed, and the matrix placement and injection molding process were repeated for the lateral incisors. The ICP occlusion for the laterals was then established, using the central incisors as a reference.
-
Matrices in-situ with delayed wedging UL1 after shaping UR1
-
Matrices in-situ with delayed wedging UL2 after shaping upper centrals
-
Immediate after polishing upper 2-2
Treatment of the upper premolars and molars involved the use of molar matrices and injection overmolding to create a combination of direct onlay/overlay restorations. Occlusion was established with ICP contacts on the upper 6-6, anterior guidance on the central incisors, and bilateral canine guidance.
This was then finished with the Bioclear Rock Star Polish, using Magic Mix and SS White Jazz Polishers.
A protective night splint was constructed for nightly wear.
-
Upper anteriors before treatment
-
Upper anteriors after treatment
-
Upper occlusal view before treatment
-
Upper occlusal view after treatment
-
Lower anteriors before treatment
-
Lower anteriors after treatment
-
Lower occlusal view before treatment
-
Lower occlusal view after treatment
He was thrilled with his new smile, regaining confidence and his original look.
Photos highlight the additive effect and smooth monolithic composite surfaces. Annual reviews include assessment, imaging if needed, and Bioclear re-polishing with the Jazz polisher to maintain the restorations.
-
After treatment
-
After treatment
X-rays of the upper and lower teeth taken one year post-treatment demonstrate the classic Bioclear shape achieved with the matrices, as well as smooth, overhang-free emergence profiles.
-
Xrays of the upper right 1 year after treatment
-
Xrays of the upper right 1 year after treatment
-
Xrays of the upper anteriors 1 year after treatment
-
X-rays of the upper left 1 year after treatment
-
Xrays of the upper left 1 year after treatment
-
Xrays of the lower right 1 year after treatment
-
Xrays of the lower left 1 year after treatment
Included are photographs taken one year post-treatment, showcasing durable restorations with excellent polish and healthy surrounding periodontal tissue.
-
Smile 1 year after treatment
-
Lower anteriors 1 year after treatment
-
Lower occlusal view 1 year after treatment
-
Upper anteriors 1 year after treatment
-
Upper occlusal view 1 year after treatment
