Central incisor restoration (Case Report)

: This case report describes the 11 tooth old restoration removal and new direct composite restoration placement(Enamel Plus, Micerium S.p.A, Avengo, Ge, Italy). Direct anterior restorations are today a very nice, minimal invasive and cheap opportunity to restore one or more teeth. With the use of modern materials, the right techniques and protocols we can obtain mimetic restorations that they can work on the mouth of the patient for a long time.


INTRODUCTION
Tooth shape is the factor that plays a predominant role in rehabilitations with aesthetic restorations in the anterior maxilla.
A frontal rehabilitation is certainly a complex process. Numerous factors need to be analyzed when designing a new dental element, dental alignment, size of the clinical crown and occlusion. Comprehensive knowledge of these aspects is essential for creating aesthetic and harmonic restorations. [1][2][3][4] Most of the materials and clinical and technical procedures are subjected to the judgment of time and are constantly evolving, the dental morphology is timeless and does not change.
Once the knowledge of dental anatomy was of primary relevance to dental technology, today, with the increased popularity and quality of direct and semiindirect restorations, this aspect becomes of fundamental importance also for the dentist.
The aim of this report is to demonstrate the direct composite restoration of 11 tooth and its follow-up.

CASE REPORT
Dental history: the patient requests the old restoration 11 to be replaced ( Figure 1). She reports that she suffered from a trauma of the tooth when she was a child due to a fall from a horse. This direct restoration was performed which has remained stable over time while losing the adequate aesthetic characteristics.
Dental examination: no periodontal problems or carious nature are highlighted.
For 11 tooth it is proposed: • diagnostic waxing of the tooth from which a silicone key will manufactured ( Figure 2); • direct composite restoration (Enamel Plus, Micerium S.p.A, Avengo, Ge, Italy). The stages and features of this case report are described in figures 3 -19.

DISCUSSION
To create aesthetically pleasing and mimetic restorations, three fundamental elements are required for morphology: Knowledge of the three basic dental morphologies: square, oval and triangular; and the ability to harmonize each element with the patient's face and teeth.
Mamelloni are considered to be anatomical divisions of the tooth and are usually separated by primary sulci. All human teeth have four or more lobes. The connections of the various surfaces give shape to the tooth. The dental morphology is therefore given by the sum of the different lobes and their interaction. Knowledge of surface texture and the ability to reproduce it enables us to also shape processes such as aging. [5] CONCLUSIONI Direct anterior restorations are today a very nice, minimal invasive and cheap opportunity to restore one or more teeth. With the use of modern materials, the right techniques and protocols we can obtain mimetic restorations that they can work on the mouth of the patient for a long time.
In a modern dentistry approach is very important to insert this procedures in our treatment plans to give more possible choice to our patients.