Patient presented with leaking margins on #8 and #9 composites. These fillings were placed when the patient was 8 years old, after a fall that caused her to fracture her central incisors. The fracture on #9 extended into the pulp and required endodontic treatment. Her chief concern was the shape and color of #8 and #9. After analyzing her radiographs we decided to place direct composite fillings rather than an indirect restoration due to the large pulp chamber and lack of pericervical dentin that might remain after preparation. First, we removed all the old composite and a portion of the coronal MTA that was placed in the pulp chamber. Next, we blocked out the discoloration with an opaque flowable composite. We used a lingual putty, that I had made off my wax up, to contour the lingual of the #8 and #9, then layered varying dentin and enamel shades. The result was an improvement over the previous restoration in both function and esthetics. The patient was pleased with the result but looks forward to the day that she can afford veneers on #7 through #10.
Case 3:
