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Clinical Case Spotlight: Enhancing Smile Aesthetics Through Precision Layering by Dr. Tommaso Mascetti

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Categories: Restorative Dentistry;
Dentaltown Magazine

Showcasing the innovative shade-matching ability of Transcend Universal Composite

by Dr. Tommaso Mascetti

When using new-generation dental composites, it’s important to understand how the features of the resin matrix and filler composition, size and quantity will affect the material both biomechanically and aesthetically. This case below utilizes Transcend Universal Composite from Ultradent.

Case presentation

A patient presented with dental misalignment and crowding teeth. A thorough analysis allowed for subtle changes to provide a solution. Examination revealed a Class II subdivision and malocclusion. The patient opted for conservative improvements without major changes (Fig. 1).

Orthodontic treatment was administered via clear aligners by Dr. Camilla Molinari. Planned restorative enhancements were incorporated into the treatment plan and commenced at the end of the orthodontic therapy (Fig. 2).

The goal was to increase the width of teeth #7 and #8 by adding volume to the distal transition lines. Particularly, to match #7 more closely #10. The mesial transition line on #8 was corrected, the incisal edge of #9 was evened out and the incisal margins of both central incisors were enhanced with small direct composite additions. Tooth #10 was reduced in length through ameloplasty on the mesial half of the incisal margin (Fig. 3).

Matrices were placed to protect and separate teeth during adhesive pretreatments, the first of which involves the application of Ultra-Etch etchant for 30 seconds (Fig. 4).

After a thorough rinse, the dental substrate was coated with Peak Universal Bond adhesive. The adhesive was gently agitated for 10 seconds, then thinned/dried for 10 seconds using one-quarter to one-half air pressure. The treated surface should then appear shiny (Fig. 5).

Light curing was performed using the VALO X curing light for 10 seconds (Fig. 6).

Transcend universal composite in both dentinal and enamel shades was then layered (Fig. 7). As illustrated in the layering scheme (Fig. 8), I used dentinal chromatic enamel (A2D and UB shades) desaturated from the cervical third of the teeth in the distal areas where transition lines were altered. For the enamel shades, I applied a slightly chromatic enamel (EN shade) in the most cervical areas of the transition lines and to reconstruct the incisal margins. A higher value enamel (EW shade) completed the outermost part of the distal transition lines, adding depth to the restorations without using intensives.

The handling, layering and finishing process was greatly simplified without compromising the overall results in terms of longevity and aesthetics (Fig. 9).
Transcend Composite Case
Fig. 1
Transcend Composite Case
Fig. 2
Transcend Composite Case
Fig. 3
Transcend Composite Case
Fig. 4
Transcend Composite Case
Fig. 5
Transcend Composite Case
Fig. 6
Transcend Composite Case
Fig. 7
Transcend Composite Case
Fig. 8
Transcend Composite Case
Fig. 9


Conclusion
What impressed me about the Transcend composite was its ease of use. The smart selection of masses offers great versatility for any situation with a minimal number of syringes. Its excellent handling allows for precise modeling of every surface, thus increasing the accuracy of results, especially in multiple restorations.
Author Bio
Dr. Tommaso Mascetti Dr. Tommaso Mascetti has a private practice in Milan, Italy, where he employs his expertise in digital planning, minimally invasive restorative dentistry and aesthetics. As an adjunct professor in restorative dentistry, he’s an author and contributor in the publication of scientific articles and books. Mascetti is an international speaker at courses and conferences and the cofounder of Re-Shape, a multidisciplinary ortho-perio-restorative course with a global approach to aesthetic dentistry.
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