Patient of 29 years. Tooth 21 had a fracture and subsequent reattachment of the fragment, it is slightly discolored and extruded with respect to the adjacent teeth.
In a case like this, the most appropriate therapy could be an orthodontic re-intrusion with possible subsequent surgical correction of the gingival levels. The patient did not intend to undergo orthodontic or surgical treatments, so it was suggested to her a restoration with the BAIR Technique, capable of realigning the 2 central units quickly and without invasive interventions.
The tooth was shortened and space had been created to correct the discoloration, due to the more opaque and chromatic dentin, with a more translucent composite.
A, B: The metal matrix is applied in the manner described above for the insulation of the class 5. Once the edge of the matrix has slipped inside the sulcus, a thrust is exerted which determines the displacement of the gum in the apical direction, until the “parabola” of the metal ring is approximately at the same height as the gingival parabola of the adjacent tooth.
C: A locally isolated operative field is obtained. This process allows the application of the adhesive system and subsequently of the composite. The composite must be adapted against the matrix and against the tooth, resulting in the modification of the emergence angle between the root and the crown. The boundary between the root and the crown (modified with the composite) moves apically.
The diagram shows, in lateral and frontal view, the new “hybrid CEJ” rebuilt at a more apical level. The gingival tissue, supported by the composite, adapts to the new emergence profile.
A: Immediately after removing the matrix, we can verify that the incisal and gingival levels have been restored.
Finishing and polishing are performed only on the extra-gingival portion of the restoration, the intrasulcular part is already smooth as it is polymerized in contact with the metal of the matrix which also prevents the inhibition of polymerization by oxygen.
B: Follow up after 2 years.