A quick tip against dehydration while doing direct bonding with composite resin in the anterior!

Often when we are performing direct bonding with composite resin in the anterior, we struggle, chasing the moving color target of an adjacent tooth that is slowly dehydrating and changing in value. A quick tip to counter this is to apply bonding agent to the surface you wish to match, often a contralateral tooth, at the beginning of the bonding procedure. It will tend to stay true and be a more reliable reference for color matching while you work. When you are finished, just polish it away!

Note how by applying bonding agent to both centrals, by the end of the procedure, both centrals look the same, while the laterals have changed significantly due to dehydration.

Try it out! It has worked consistently for me.

Restoring Fractured Front Teeth

Case Type: Class IV direct resin, #7 and #8

A young patient presented with fractured incisors after a hiking trip.   Direct bonding was selected as treatment of choice for its conservative nature.   Micro-etching was the only preparation done.   Teeth were etched, bonded, and layered with dentin and enamel shades of composite.   Teeth were contoured and polished to mimic the patient's natural dentition.

Pre-op fractured incisors

A mock-up was used to create a sil-tech lingual/incisal guide, and a B1 dentin from Four Seasons was used for the build-up of the incisal edge and dentinal lobes.

An opalecent composite from Omega Estilite was placed at the incisal and a B1 enamel from Filtech Supreme was placed as a final outer enamel layer.

Contouring was done with a fine diamond and flexidiscs, followed by Enamelize paste from Cosmodent.

After evaluating the post-op photos, I see that it will be nice to have the patient return to correct the width of #8 in order to make it more symmetrical with #9, fine-tune the polish, and have a follow-up with the patient.