This 50 year old lady presented with black triangles following the stabilization of her periodontal disease. Having never experienced black triangles before, she was highly self-conscious about the appearance of her teeth and smile, which was negatively impacting her recovery and self-esteem. She researched black triangles and sought minimally invasive Bioclear composite bonding as a solution to address her concerns
The black triangles were measured using the Bioclear Black Trinagle gauge, and anatomical mylar Bioclear matrices were selected and tried-in to ensure the proper emergence profile with the surrounding gingiva and papillae.
A rubber dam was applied, and the teeth were disclosed to facilitate thorough biofilm removal using aluminum trihydroxide powder and Aquasol solution (Aquacare). No tooth preparation was required.
Matrices were positioned on the first tooth both mesially and distally, using a combination of anterior and black triangle matrices for this case. Shield matrices were placed on adjacent teeth to protect the surrounding spaces
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Bioclear Black Triangle gauge in-situ to measure the triangle for matrix selection
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Try-in anatomical Bioclear Black Triangle matrices before rubber dam placement
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Matrices in place after Biofilm removal
Bioclear Injection Moulding was performed using 3M™ Scotchbond™ Universal Plus Adhesive, warmed 3M™ Filtek™ Supreme Flowable, and 3M™ Filtek™ Supreme XTE Universal body paste composite in shade A2. The central incisor was sculpted and shaped using 3M™ Sof-Lex coarse and medium discs. This process was then repeated for the second central incisor and the lateral incisors
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UL1 after injection over-moulding
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Upper central incisors after shaping, before proceeding with lateral incisors
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UR2 after injection over-moulding
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.
She was very pleased with the results on her upper teeth. At her review appointment, her periodontal health and homecare routine were assessed and confirmed to be in good condition.
Following this, she expressed interest in not only closing the black triangles on her upper teeth but also addressing the black triangles on her lower teeth and the natural diastemas between her lower canines and premolars. The same treatment process was then applied to her lower arch.
As with all cosmetic composite treatments, she now attends annual review appointments. During these visits, the restorations are assessed, and radiographs and photographs may be taken if needed. Bioclear maintenance, which involves re-polishing the composite using the Jazz polisher, may also be performed to maintain the restorations.
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Upper incisors after polish and Black Triangle closure, lower Black Triangles remain untreated.
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Upper incisors after Black Triangle closure
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Retracted view after treatment of upper and lower Black Triangles
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Smile after treatment
X-rays of the upper and lower incisors taken two years post-treatment demonstrate the classic Bioclear shape achieved with the matrices, as well as smooth, overhang-free emergence profiles
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Xrays of the upper incisors 2 years after treatment
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Xrays of the LR123 2 years after treatment
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Xrays of the LL123 2 years after treatment
Included are photographs taken three years post-treatment, showcasing durable restorations with excellent polish and healthy surrounding periodontal tissue.
The patient continues regular visits with her local hygiene team, and no adverse periodontal effects from the treatment have been observed.
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Retracted view 3 years after treatment of upper and lower Black Triangles
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Lower anterior teeth 3 years after treatment showing Bioclear restorations and good gingival health.
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Upper anterior teeth with contraster 3 years after treatment showing Bioclear restorations and good gingival health.
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Smile 3 years after treatment
