Slideshow by Dennis B. Hartlieb, DDS

1. Conservative Esthetic Treatment
for the Adolescent Patient
Slideshow by Dennis B. Hartlieb, DDS

2. Dark substrate, right central incisor.Vita shade-based opaquer used to blend
composite to tooth structure.

3. Pink opaquer applied to raise value of tooth
structure.
Pink opaquer placed in gingival and body
thirds of #8; value mimics the contralateral
central incisor.

4. Tints placed to add intrinsic effects.

5. Chromatic dentin layer placed to be veneered
with high-value enamel layer.
Less chromatic dentin shade that matches
viewed shade of tooth.

6. Initial smile, right Initial smile, left.

7. Initial smile, frontal.

8. Esthetic crown lengthening completed. Tissue contouring with radiosurgery.

9. Roughening of enamel with fine diamond bur. Roughening of defect with microbur.

10. Etching of enamel with 37% phosphoric acid. Clear contoured matrix positioned.

11. Placement of initial increment of nanofill
composite.
Mesial-lingual wall created.

12. Incisal-lingual extension placed. Vita shade-based opaquer used to block out
shine-through of composite.

13. Black and white image to evaluate shine-through
of composite and block out effect.
White tint to replicate intrinsic hypocalcification
effect.

14. Grey tint placed to create translucency effect. Translucent microfill placed for incisal third.

15. More chromatic microfill placed in gingival third. Body shade microfill placed.

16. Final contour from incisal view prior to
contouring.
Carbide ET bur for contouring.

17. Coarse disc used for additional contouring. Contouring and polishing of distal contact.

18. Distal contact polishing continued. Final polishing distal contact.

19. Etching of canine for direct resin placement. Placement of nanofilled composite for mesial
wall of canine.

20. Sculpting of nanofilled composite. Nanofilled composite layer completed.

21. Opaquer being placed to block out shine-through
and blend composite to tooth.
White tint placed.

22. Translucent microfill for incisal third. Body microfill placed.

23. Sculpting body microfill. Trimming composite with mosquito bur.

24. Polishing cup with subgingival flex for polish at
margin.
Final polishing with subgingival flex for polish at
margin.

25. Final contouring with medium coarse disc. Surface texture and effects created with
aluminum oxide brush.

26. Polishing with flexible disc. Final polishing with disc.

27. Final smile, left lateral view. Final bonded restorations, #6, #7, #10, and #11.

28. Final polish lateral view, #6 and #7.

29. As demand for cosmetic dentistry continues to grow, it
helps to be more familiar with the materials available for
direct resin placement, the layering options available,
and the techniques to create composite restorations
that blend with the patient’s natural dentition.

30. Improve your skills at
AACD 2016 Toronto!
www.aacd.com/conference