Anterior Traumatic Fractures Resulting from a Fall - K. G Feb 2023

Anterior Traumatic Fractures Resulting from a Fall

This 55-year-old patient presented with traumatic fractures of his three front teeth following a fall. He was also concerned about visible stained cracks in his front teeth.

Preferring to avoid indirect porcelain restorations, he sought a minimally invasive, additive, yet strong and durable solution. He opted for Bioclear composite restorations for the fractured teeth. The natural characterization of the left lateral incisor was discussed, as it might appear cosmetically distinct from the Bioclear restorations post-treatment. He was informed about the option to apply a Bioclear restoration to the left lateral incisor in the future to achieve bilateral cosmetic symmetry if desired.

The goal was to restore the teeth to their original size and shape whilst belnding with the adjacent natrual teeth for a harmonious and aesthetic result"

A rubber dam was placed, and thorough biofilm removal was performed using aluminium trihydroxide powder and Aquasol solution (Aquacare). The teeth were treated individually. Temporary composite material was removed, and any necessary preparation was completed.

Bioclear matrices were then placed, using a combination of Anterior and Black Triangle matrices for this case. Shield matrices were placed on adjacent teeth to protect the surrounding spaces.

The Bioclear Injection Molding technique was utilized, employing 3M™ Scotchbond™ Universal Plus Adhesive, warmed 3M™ Filtek™ Supreme Flowable , and 3M™ Filtek™ Supreme XTE Universal body paste composite in shade C2.

Preparation UR1
UR1 matrices in place after composite removal and preparation
UR1 after injection over-moulding

1 4

The first central incisor was sculpted and refined using large and small 3M™ Sof-Lex™ coarse and medium discs.
This process was subsequently repeated for the second central incisor and lateral incisor.

UL1 matrices in place after shaping UR1 and preparation UL1
After sculpting and confirming symmetry central incisors
UR2 matrices in place

1 4

After careful final sculpting of the three teeth, the Bioclear Rock Star Polish was completed using Bioclear Magic Mix and SS White Jazz Polishers, achieving a consistent shine whether the teeth are wet or dry.

Note the dehydration of the adjacent teeth which were isolated with the rubber dam during treatment.

UR2 after injection over-moulding
After Rock Star Polish
Immediately after treatment (note dehydration)

1 4

He was very pleased with the appearance of his new teeth and chose not to treat the left lateral incisor, despite preferring the appearance of the Bioclear restorations.

Thanks to the additive nature of the Bioclear treatment, multiple options remain available for future re-treatment cycles, including the possibility of reapplying Bioclear. Additionally, should the teeth become non-vital, access can be gained and resealed palatally for endodontic treatment.