Crown fracture and stratification of composite restorations: replication of natural aesthetics

Presenting problemTraumatic dental injuries are frequent accidents that typically involve the maxillary anterior segment, where the most common injuries are crown fractures.Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan.It is also important to consider the biological, functional, aesthetic and economic aspects, as well as the patient’s desire.Clinical managementThe success depends on a harmonious integration of various elements, including a thorough knowledge of the internal structure of natural dentition, aesthetics, characteristics of current materials, and restorative techniques.A natural appearing aesthetics result can be achieved in a relatively simple and predictable manner: anatomic stratification with successive layers of dentin, enamel, and incisal composite.General dentists might find the proposed techniques to be complicated and demanding because bonding techniques are still considered intricate, sensitive and unpredictable.This doubt can be overcome by the application of the “natural layering concept” which makes use of only two basic masses, dentin and enamel, perfectly mimicking natural tooth structure.The objective of this article is to present a personalized technique of stratification for each individual case in direct composite restorations.DiscussionThe presented protocol makes highly aesthetic restorations simple yet predictable. Identification and reproduction of the natural anatomy and nuance colour characteristics exhibited by natural dentition with composite resin, thought a detailed evaluation of hue, chroma, opalescence and fluorescence, allow the dentist to satisfy most aesthetic demands and it offers an interesting alternative, minimizing invasiveness, chair time and costs for patients.