Reabilitação estética do sorriso: relato de caso

Abstract

This study aimed to rehabilitate the smile of a patient dissatisfied with aesthetics and dental harmony. After signing the Informed Consent Form, patient L.P.M.F attended the Restorative Dentistry section at UFJF-GV, where his smile rehabilitation was planned. Initially, dental bleaching was performed by the combined technique (in office and at-home); the initial color was B3 according to the Vitapan Classical scale, which acquired a whiter shade (A1). Then, eight composite resin restorations were made, trying to correct the inversion of the smile line, which was inverted; also, the patient did not have canine guide occlusion and he presented a defective resin restoration on tooth 11. Class IV restorations were made on teeth 13, 23, 33 and 43 for the return of the patient's lateral canine guide. In turn, teeth 12, 11, 21 and 22 were restored by the direct veneer technique with composite resins. All restorations were performed using a conventional 3-step adhesive system (Scotchbond Multipurpose; 3M ESPE) and various composite resins indicated for the restoration of enamel, dentin and the effects of translucent zone and opaque halo. The restorations were polymerized as recommended by the respective manufacturers, followed by finishing and polishing with various materials. In the immediate moment after the restorative treatment, the patient expressed contentment with the new aspect of his smile. After 6 months, he returned for maintenance. From the evaluation using the modified USPHS criteria, the restorations were considered in an acceptable clinical state, requiring only finishing and polishing, since most of them were rough and lacking surface gloss. The only exception was the veneer performed on tooth 11, which demonstrated loss of marginal integrity and significant discoloration on the palatal face. After repairing the defective portion of tooth 11 and performing the finishing and polishing procedures of all other restorations, the patient was relocated in the maintenance program. In conclusion, the smile rehabilitation using a direct technique with composite resins is a suitable and simple procedure, but it may require periodic maintenance, especially through finishing and polishing procedures. Also, if minor defects need to be corrected, the resin restoration repair protocol is easy and can increase the clinical longevity of the restorative treatment.