Anterior Esthetic Restorations with the Stratified Stamp Technique: A Case Report

Abstract

Anterior teeth restoration represents a challenge for dentists, who often rely on the dental technician's wax-up. The proposed Stratified Stamp Technique (SST) allows for clinically reproducing the wax-up in a quick and easy way. A patient with fractures and discoloration on the upper central incisors was treated with resin-based composite direct restorations. Using SST, a 1 mm thick thermoformed polyethylene-terephthalate-glycol (PETG) template, based on the technician's wax-up, was produced. Enamel Selective Area Reduction (SAR) was performed to guarantee adequate space for the restorations, and the fracture margins were rounded and finished. Traditional layering procedures according to the five color dimensions of teeth were performed, except for the final labial layer, which was realized with warm composite loaded inside the template and polymerized through it, in order to ensure accurate tooth morphology reproduction. SST offers a reliable method for transferring technician's wax-up morphology to direct composite restorations in anterior teeth. Compared with other methods, SST allows for better isolation with a rubber dam and permits traditional layering with multiple composite shades, thus leading to satisfactory esthetic outcomes.

Keywords: case report; dental trauma; direct composite veneer.

Figure 1

(A) Intraoral photo showing an enamel fracture on tooth 1.1 and an enamel–dentin fracture with severe discoloration on tooth 2.1. (B) Radiograph showing radiolucency on tooth 2.1.

Figure 2

(A) Plaster study model of the patient’s upper and lower arch. (B) Additive wax-up of the central incisors made on a plster study model duplicate. (C) 1 mm thick thermoformed polyethylene-terephthalate-glycol template copying the shapes of the wax-up.

Figure 3

Areas of enamel to be reduced marked on both (A) the wax-up and (B) the patient’s teeth. (C) Enamel Selective Area Reduction performed and fracture margins rounded and finished. (D) Passive fit of the template confirmed.

Figure 4

(A) Final esthetic result. (B) Radiographic check for the absence of any excess material in the cervical area.

Figure 5

(A) One-year clinical follow-up showing a well preserved and stable esthetic outcome. (B) Upper front teeth at the 1-year follow-up.