Multidisciplinary approach for the closure of multiple diastemata with composite resin.

Morphologic anterior tooth alterations and diastemata between the anterior teeth are often considered a major esthetic problem. In most cases, the treatment of these conditions involves a multidisciplinary approach. Orthodontic treatment together with direct composite resin veneers are a viable option to close diastemata and alter tooth shape. The extent and etiology of the diastemata must be considered and properly evaluated for the treatment. The present article is a case report of a patient with multiple diastemata in the maxillary anterior teeth, dental crowding, and peg-shaped lateral incisors corrected with orthodontic treatment and direct composite resin veneers. Digital planning was the tool used to decide the tooth proportions before orthodontic treatment and to guide the diagnostic wax-up. An etch-and-rinse adhesive system was applied after etching. A polychromatic layering technique under rubber dam isolation was used for the composite resin veneer construction. Finishing and polishing procedures were achieved using polishing discs and abrasive materials. Direct composite resin is an alternative that allows predictability, esthetics, and the possibility of adjustments, resulting in patient satisfaction.

Influence of ferrule, post system, and length on biomechanical behavior of endodontically treated anterior teeth.

INTRODUCTION: The aim of this study was to evaluate the influence of post system, length, and ferrule on biomechanical behavior of endodontically treated anterior teeth. METHODS: The investigation was conducted by using laboratory tests and 3-dimensional finite element analysis. Eighty bovine incisors were selected and divided into 8 treatment groups (n = 10) with absence of ferrule and 2.0 mm of ferrule, restored with glass fiber post or cast post and core, and 12.0 and 7.0 mm of post length. The specimens were loaded at 135° angle, and the strain was measured by using strain gauge method. Specimens were subsequently loaded until fracture. Strain and fracture resistance results were analyzed by 3-way analysis of variance and Tukey honestly significant difference tests (α = 0.05). Three-dimensional models of a maxillary central incisor were generated with the same treatment variations used in laboratory tests. Each model was subjected to 100 N oblique loads. Results were evaluated by von Mises criterion. RESULTS: Ferrule was a determining factor in the strain, fracture resistance, and fracture pattern. In the absence of ferrule, the use of fiberglass posts represents a conservative choice from the standpoint of the fracture patterns observed. The length of 7 mm for cast post and cores produced high rates of root fractures. Finite element analysis showed that glass fiber post showed homogeneous stress distribution, whereas cast post showed stress concentration into root canal. CONCLUSIONS: Post length influenced only the cast post strain and stress distribution. The ferrule groups always showed more satisfactory stress distribution and fracture resistance.