Dr Rajiv Ruwala qualified from King’s College London in 2008. He is a Principal Dentist and Facial Aesthetics Practitioner, and currently runs 2 Green Dental Practice in Dartford. He offers surgical dentistry including implants and gum grafting surgery, as well as smile makeovers, orthodontics, and general dentistry. Rajiv is dedicated to teaching. He has received a PgCert for Dental Education from the University of Bedfordshire, and has offered training and education through the London Deanery, King’s College Dental Institute, and BDA.
Here, he presents a restorative case which uses composite bonding to improve his patient’s smile aesthetics.
Patient background
A patient presented to the practice who wanted to know more about composite bonding. She wanted to improve the aesthetics of her teeth, with the aim to give her self-confidence a boost.
Assessment and diagnosis
The patient’s suitability for restorative treatment was assessed. This involved carrying out a Basic Periodontal Examination (BPE) which found BPE scores of 212 in the upper dentition, and 222 in the lower. Her overall oral health and hygiene was good, and she had caries in her UL5 which had been restored using composite.
Treatment planning
During the treatment planning stages, whitening and composite bonding were discussed. As the patient was particularly interested in composite bonding, planning and treatment using SmileFast was discussed, as well as the use of a trial smile, and bonding the teeth immediately afterwards.
Treatment provision
SmileFast was used to create a 3D design. This was approved digitally, and the appearance verified with the patient with a trial smile. Once verified, a stent was fabricated that features strips which fit between the patient’s teeth. In this case, BRILLIANT Everglow™ from COLTENE was used in shade Opaque Bleach (OBL) – this is the brightest white shade available whilst not to everybody’s taste, this was the patient’s preference. The stent was trialled, prior to composite placement, to ensure a good fit.
BRILLIANT Everglow™ was then heated to 65°C and placed inside the stent. This allows the composite material to be placed on all teeth at once. Following placement of the composite, the material was light cured through the stent first, and then through glycerin. Once cured, the stent was removed and the teeth were polished. Polishing rubber, diamond discs, and diamond polishing paste were used to achieve a nice finish
Outcome
Both the patient and I were happy with the results of this treatment. We were able to achieve our initial goal, creating a white, bright smile to help her feel more confident.
Case appraisal
Having reflected on this case, I can appreciate that the OBL shade of the BRILLIANT Everglow™ composite allows you to achieve an in-your-face look. This is exactly what the patient was hoping for, and she was happy with the aesthetic result. My advice to other dentists who are looking to achieve a bright white smile is to be sure to add texture to help achieve a more natural looking finish.
COLTENE offers a wide range of restorative products to help dentists and their patients achieve their desired look. The range includes the BRILLIANT Everglow™ composite material which is available in an array of shades including dentine shades and the brightest white bleach shades. COLTENE aims to meet the aesthetic desires of each patient, which makes this composite the ideal choice.
For more information, info.uk@coltene.com and 0800 254 5115
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