Dr. Susan McMahon is a practicing dentist and educator in Pittsburgh, PA. She shares tips for great looking anterior composite work.
Dr. Susan McMahon is a practicing general dentist in Pittsburgh and I AACD certified focusing on cosmetics. She has been an associate, a private practice owner, sold to a DSO, and eventually became a practice owner again.
We are focusing on anterior composites specifically. With the interest in cosmetic dentistry, a less is more approach can be very effective if you learn to do good composite work. In looking at the example, you can see that the color is good, but the sheen is dull and the composite plane is flat. The anatomy is slightly off. Moving from the facial plane to the interproximal plane, we can see there is no corner. Additionally, the lobes are not present, which does not look natural. The angles are important because light reflection is affected. Over polishing also loses much of the natural-looking surface texture. Striations on the tooth are found in nature. Mixing a translucent and body shade composite also gives a natural look.
Use a disk to get the angle at first, next use a coarse diamond dry and move it very slowly at about 20,000RPM. Go over the entire surface, then create the lobes, before flipping it longways to create the striated lines. The coarse diamond is great for surface texture.
Use a medium spiral polisher followed by a fine spiral polisher and finish up with a jiffy brush with diamond paste if needed. Polisher speed should only be about 8000RPM to preserve the lines and lobes created with your composite.
A direct veneer is a great product that is easy to use and fast. U-Veneer has a mold kit that will help match the desired tooth structure and includes the surface anatomy you want. The process involves isolating the tooth, etch, apply the adhesive, cure, then fill the mold with your composite. Overfilling slightly is important. Place the filled mold onto the tooth making sure to prevent air bubbles, and clear the excess with an explorer. Finish it the same way as with the composite, coarse diamond followed by polishing steps. The surface texture is heavy on the mold, so it gives you options to create the most accurate surface texture.
This is a great option because it is 100% reversible, has no reduction in tooth structure, a provides a great result.
What is the best way to follow you? Her schedule is on Catapult Education. She will also be at the Chicago Midwinter meeting talking about minimally invasive cosmetics for young adults.