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About the Case

A 65-year-old male presented with a chief complaint of wanting a more ideal smile. His teeth had shifted in the time since he completed orthodontic treatment as a teenager, resulting in diastemas and noticeable wear. It was important to him that any treatment done be as conservative as possible with minimal removal of healthy tooth structure. Upon examination of his smile, it was noted that patient had spaces between several of his front incisors and his central incisors were pushed lingually, out of alignment. He also had short, flat canines that had worn over the years. After a discussion of treatment options, the patient was not interested in orthodontic treatment nor in utilizing porcelain in his treatment due to cost and his desire to preserve tooth structure. It was decided that we could address all his concerns utilizing composite and the 3M Filtek Matrix. Typically, utilizing composite to close multiple diastemas and manually re-shape and lengthen teeth can be time-consuming, unpredictable and quite frustrating for a dentist. The time and expertise required to achieve ideal results can also result in treatment costs that can be prohibitive for the patient. In this case, utilizing the 3M™ Filtek™ Matrix solved all these concerns by providing a template that allowed ideal contours and shape of the teeth while reducing the time needed to achieve a more esthetic smile. Using composite in this case allowed me to have maximum control of the esthetics of the case and had the added benefit of no additional porcelain lab costs for the patient. The tooth contours can be easily adjusted by finishing or by adding more composite. Additionally, composite allows me some creative design with finishing and polishing. The patient states that he feels very proud of his new smile, and he just can’t stop smiling! Refer to Instructions for Use (IFU) for complete product information. Results may vary.
Initial situation
3M™ Filtek™ Matrix secured in place using a clamping mechanism at the distal ends of the device. The matrix is initially tried in to verify the fit.
After confirming matrix fit, air polishing removes plaque and biofilm (Bioclear™ Blaster with Aluminum Trihydroxide Powder).
Preparation
3D printed view
In preparation for bonding, the teeth are etched with 3M™ Scotchbond™ Universal Etchant, rinsed and dried.
3M™ Scotchbond™ Universal Plus Adhesive is applied, rubbed (20 sec), air dried (5 sec), and light cured (10 sec).
3M™ Ketac™ Universal Aplicap™ Glass Ionomer Restorative
Application of adhesive
The gingival margin is lined with 3M™ Filtek™ Supreme Flowable Restorative A1. The matrix door is closed for light curing.
3M™ Filtek™ Supreme Ultra Universal Restorative A1B is injected into the matrix window. Each tooth is slightly overfilled.
Preparation ready for bonding
bite-wing radiograph
The matrix door is closed with enough force to feel the latch snap. Excess composite is removed from the facial vent hole and the door’s edges.
The composite was cured from both the facial and lingual surfaces to ensure complete polymerization.
3M™ Sof-Lex™ Pre-Polishing Spirals (Beige)
The teeth immediately after matrix removal (top) and after finishing and polishing (bottom).