A “Simple” (but not easy!) Cosmetic Bonding Case

Taking a brief break from the Coronavirus hysteria (I’m not done!) to post some dentistry.  A friend just boldly posted on Facebook:  “Stay home. Close your business. Don’t go out. Live in fear….  No thanks!”

Me, neither!  I did this case today.  It had been planned for months.  Patient is a young woman who has some congenital dental issues.  She has had cosmetic bonding done twice before.  Her chief complaint was the appearance of teeth #s 6, 7, and 10.

#6 is mesially tilted and rotated.  #7 is a peg lateral (as you’ll see).  #10 is actually #11.  The tooth in position #11 is a retained deciduous canine. 

We talked about all options including ortho and veneers.  She wanted minimally invasive and “minimally expensive” treatment.  She asked if I could JUST re-do the bonding.  I sure can!

Here are some side views:

Here’s a close-up of #s 6 and 7.  Pretty, eh?

Here’s the occlusal view, which reveals the size discrepancy between #s 7 and 10.

I took an impression, so I could play with it in the lab and do a wax-up and then make a SilTec putty matrix.

Nothing fancy… just trying to get an idea of what I can do.

The patient wanted to whiten first, which took her from an A-1 to about an 040 bleach shade.

Today she came in for the restorative part.  Honestly, I did not anticipate the amount of time it would take to remove the old bonding carefully while being minimally invasive.

Here’s the “before” and after carefully removing the old composite material from #s 6 and 7.  How do you like that lateral??  😮  Yowza!

Here we go!  I felt the KEY to this case was getting #7 looking decent FIRST.  I used the putty matrix to get an initial incisal edge shape.

Voila!

Fill in the blanks, build it up, and #7 takes shape!  Not bad! 

Then on to #6!  I used the matrix the same way.  OK… not bad. 

I forgot to get a photo of #10 stripped of the old composite.  But, once I did, it was a perfect canine (actually a mesialized #11).  I flattened the prominence on the central part of the facial and made the incisal shape to mimic a lateral incisor.  I curved the distal incisal corner to try to create an optical illusion of being more narrow. 

Here’s the final result of all three restored teeth:

She’ll be back for some minor tweaking next week.  Overall, a decent result, considering the limited approach.  We may come back and try to do something with the deciduous canine in position #11.

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16 Responses to A “Simple” (but not easy!) Cosmetic Bonding Case

  1. Sue says:

    Mike, What are you going to do with the extra $1000 you get?

    • The Dental Warrior says:

      What $1000? I’m not expecting any gifts. You sending me something? 😉

      • Sue says:

        You have not heard about the $1 trillion economic stimulus package? You are joking, right? Seriously, you can’t be that out of touch with the news . You are joking. right?

        • The Dental Warrior says:

          I think it’s a joke. I don’t believe them. Literally do not believe them.

          And, $1000 would be NOTHING for the working people who have had the rug pulled out from under them with no warning. What the gov’t has done is IMMORAL, unconscionable, and despicable. What is even more stunning is that so many SHEEPLE have GLADLY traded their Freedom for perceived security. The same gov’t that is shutting down businesses and taking away the people’s ability to earn a living are the same ones that urged everyone to go VOTE last Tuesday. Fuck them. Fuck them ALL. We are on our own.

          I predict that the the cooperative natives’ patience will wear VERY thin, very quickly, when REALITY smacks them upside da head. That “$1000” will probably never come… or come way too late… and is way too little. It’s a fucking pittance and a fucking joke. When they start getting eviction notices and their cars are repossessed and they can’t feed their families… That’s when things are going to get VERY “interesting.” Stay frosty.

          I quit watching the TV news in August 2017 (after watching morning and night for 35+ years).

          • Sue says:

            It may not be approved. Supposed be $1000 for each adult and $500 for each child.

            If they are going to do it, it seems that the money should be targeted to specific populations rather than doled out across the board.

  2. Sue says:

    The smiley did not go through 🙂

  3. Sue says:

    PS Staying home AND living joyfully, creatively, happily and using this time as an opportunity to do things that I may not have EVER gotten around to. How many unread books do you have on your shelves?

  4. Sue says:

    Also – it’s raining hard here. So no real incentive to go out. Split pea soup with bacon … listening to Sandhill cranes squawking … 2 geese, several ducks… a flurry of life going on in our back yard. 🙂

    In good health,

    Sue

  5. Sue says:

    For instance, your business is booming, so your $3000 would go to the family that has had the rug pulled out from under them.

    I think the whole idea is weird, actually (The proposal)

    • The Dental Warrior says:

      My business is BOOMING?? LOL! You know something I don’t know?

      A lot of businesses WERE booming, until the government lackeys immorally shut them down.

  6. Sue says:

    I wonder…. why would the government shut down entire businesses?

    I wonder if this might be a little different than H1N1, Mers, Ebola, AIDs. Hep C….

    Hmm…

    Are they just doing this for show?

  7. Sue says:

    By the way, the case you presented looks good. I meant to tell you that.

  8. Sue says:

    Hurt them for now. Lots of disruption. I don’t have a crystal ball into the future, Just trying to roll with the punches and maintain the good old American spirit…

  9. Sue says:

    Hi Mike,

    It looks like Governor DeSantis has changed his mind. Minor tweaking might have to wait until May 8, 2020. 🙁

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