55 year old patient, agenesis of 1.2 and 2.2, corrected on the left side with a fiber/composite Maryland bridge, performed many years earlier. On the right, 1.3 has migrated mesially, closing the space and placing itself in place of tooth 1.2. The teeth 1.1 and 1.3 are extruded with respect to the teeth of the contralateral hemiarch. The right central incisor is also set back and inclined toward the palate so as to determine a localized overbite. There are numerous further problems of alignment and non-optimal occlusal relationships in the other sectors which, however, do not lead to functional deficiency or painful symptoms.
The patient’s request was to re-do an old restoration on tooth 11 re-done with the hope of improving her smile a little. A correct treatment plan should include a first orthodontic phase followed by a possible surgical correction of the gingival levels and prosthetic finalization. However, the patient had no intention of undergoing long and complex treatments, so it was suggested to her the BAIR Technique on the 1.1 to harmonize the 2 central ones and transform the 1.3 into a lateral incisor.
The procedure lasted about 1 hour and required a limited reduction of the incisal margin of the 1.1 and of the cusp of the canine (A).
As soon as the treatment is finished, an ischemic area is noted in correspondence with the tissues that have been moved from the matrix and kept in position by the new emergence profile designed by the composite (A). The soft tissues return to a normal state and color in times ranging from a few minutes to a few hours, without causing any suffering or damage. Follow ups after 6 (B) and 16 months (C) showed that periodontal health was maintained. The two elements treated, in an occlusal view (D), appear thicker to allow a more harmonious realignment compared to the starting situation.
Follow up at 16 months with x-ray