Peg Laterals and Worn/Chipped Central Incisors

This 28-year-old patient presented with traditional composite bonding on her undersized peg laterals, feeling self-conscious about staining, small size, and spacing. She was also concerned about her worn, chipped central incisors with grey, translucent tips.

Case by Dr Claire Burgess

Wishing to avoid porcelain restorations due to her age, she chose a minimally invasive, additive solution with Bioclear composite restorations for her front four teeth.

The objective was to restore the teeth to proper size and shape, achieve proportionate alignment with the canines, close gaps, and rebuild the worn tips for a more harmonious and aesthetic appearance.

To address the inadequate facial emergence profile of the peg laterals, Bioclear Root Overlays were applied before rubber dam placement. Old composites were removed, biofilm was removed facially, and Root Overlays were created using 3M™ Scotchbond™ Universal Plus Adhesive and 3M™ Filtek™ Supreme Flowable in inverted Bioclear Black Triangle matrices. These were then sculpted with diamond burs.

A rubber dam was placed, and biofilm removal was completed with aluminum trihydroxide powder and Aquasol (Aquacare). Bioclear matrices were then placed, a combination of Anterior, Black Triangle, and veneer matrices were used in this case.

  • Root Overlay UR2

  • Root Overlay UL2

  • UR1 matrices following rubber dam isolation and Biofilm removal

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The Bioclear Injection Moulding technique, using 3M™ Scotchbond™ Universal Plus Adhesive, warmed 3M™ Filtek™ Supreme Flowable, and 3M™ Filtek™ Supreme XTE Universal composite (shade A1), was applied to the first central incisor. The tooth was shaped and refined with diamonds and 3M™ Sof-Lex™ discs. The process was repeated for the second central incisor.

For the lateral incisors, the "delayed wedging" technique ensured space closure before injection molding.

  • UR1 after injection over-moulding

  • UL1 matrices in place after shaping UR1

  • UR2 matrices in place after hip placement and delayed wedging

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The process was repeated for the second lateral incisor, and all teeth were refined with 3M™ Sof-Lex™ medium discs, with proportions confirmed before polishing.

  • UL2 matrices in place after hip placement and delayed wedging

  • UL2 after injection over-moulding

  • Shaping complete pre polish

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The Bioclear Rock Star Polish, using Magic Mix and SS White Jazz Polishers, achieved a consistent shine when both wet and dry.

She was thrilled with the uniform, symmetrical results on her upper teeth.

  • After Rock Star Polish

  • Immediately after treatment

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Periapical radiographs taken before and two years post-treatment highlight the classic Bioclear shape achieved with the matrices and the smooth, overhang-free emergence profiles.

  • Periapical UR12 before treatment

  • Periapical UL12 before treatment

  • Periapical UR12 2 years after treatment

  • Periapical UR12 2 years after treatment

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She was thrilled with her new smile, feeling more confident in her interactions.

At her review, her periodontal health and home care were excellent. She now attends annual reviews for monitoring, which may include radiographs, photos, and Bioclear maintenance, like re-polishing with the Jazz polisher.

The additive nature of Bioclear allows for future treatment options, including re-Bioclear.

  • After treatment

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  • Smile before treatment

  • Smile 2 years after treatment

  • Before treatment

  • 2 years after treatment

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