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Case Reports
. 2018 Apr-Jun;9(2):323-325.
doi: 10.4103/ccd.ccd_36_18.

Esthetic Management of a Patient with Severely Fluorosed Enamel and Pigmented Gingiva: A Conservative Approach

Sana Ali  1 , Padmanabh Jha  1 , Usman Khan  2
Affiliations
Case Reports

Esthetic Management of a Patient with Severely Fluorosed Enamel and Pigmented Gingiva: A Conservative Approach

Sana Ali et al. Contemp Clin Dent. 2018 Apr-Jun.

Abstract

Isolated brown or white defects of less than few tenths of millimeter depth can be successfully treated with microabrasion. However, for deeper enamel defects, a combination of various techniques such as microabrasion/macroabrasion along with bleaching or full or partial veneering are available. Template-assisted direct veneering technique helps for better separation and contouring of individual tooth through which composite resin can be applied directly to tooth structure and artistically sculpted. Frequently, the gingival hyperpigmentation is caused by excessive melanin deposits mainly located in the basal and suprabasal cell layers of the epithelium. Recently, laser ablation has been recognized as one of the most effective, pleasant, and reliable techniques. This article describes a conservative approach for a complete smile makeover of a patient with severe fluorosis and pigmented gingiva with the help of enamel microabrasion and template-assisted direct composite veneering followed by laser depigmentation of gingiva.

Keywords: Composite veneering; fluorosis; laser depigmentation; microabrasion; template-assisted veneering.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Preoperative view of maxillary incisors and canines showing mottled enamel surface. (b) Macroabrasion with a fine grit finishing bur. (c) Microabrasive paste application. (d) Mechanical rubbing of abrasive using a rubber cup. (e) Rinsing of the abrasive paste with water. (f) Immediate postoperative view after microabrasion. (g) Resin mock-up. (h) Template with injection portals and interproximal slits. (i-l) Conservative reduction for veneer
Figure 2
Figure 2
(a) Mylar strip application through interproximal slits in template. (b) Composite placement through injection portals in template. (c) Postoperative view after direct composite veneering of maxillary anteriors. (d) Diode laser equipment. (e) Laser depigmentation procedure with diode laser for maxillary arch. (f) Seven-day postoperative view after depigmentation of maxillary arch
See this image and copyright information in PMC

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