Composite restoration and build-ups

Case 1 - Direct post plus composite build up, Endo and RPD

CC:

Fractured teeth 12 and a few months later fractured 22. Lack of posterior occlusion - Periodontitis with mobility grade 2 on 14, 24

Treatment:

1- Upper acrylic denture made for patient to reduce occlusion load on anterior teeth

2- Periodontal therapy

3- Patient couldn't afford indirect post and crown but was really concern about her aesthetic and didn't want to extract her teeth - decided for Elective RCT on 12 and 22 followed by composite buildup.

4- Due to severe Perio, patient was advised to add teeth to the upper acrylic denture in case of another fracture or extraction of her upper teeth

5- Regular recall and Periodontal NST - patient is being treated by me for the past 3 years.

Patient has moved to Toowoomba in early 2020 but still comes to see me on the Gold coast for her dental treatments.

Fractured tooth 22

Composite build up

Patient's feedback

Fractured tooth 22

1/6

Case 2 - Upper anterior composite build up

CC:

Patient was aesthetically concerned and didn't want to proceed with any orthodontic treatment, porcelain veneers or other indirect options. Offered her composite build up and she accepted.

Treatment:

1- Chcek up and clean (with airflow EMS machine)to make sure mouth is caries free and prepare the tooth surface for composite bonding

2- Composite mock up and get concent from patient about shape and colour of the teeth

3- Composite build up - free hand plus polishing

4- Regular recall every 6 months