Resin Composite Build-up on a Fracture Tooth

April 8, 2013 by Dr. Chong
This young girl  had an  accident at home, causing two-third of her crown fractured and worse of all, the pulp of the tooth exposed. Composite-Build-up-01 [1600x1200] We did an emergency root treatment over the tooth to reduce her pain and later on, build back the tooth (below)… Composite-Build-up-11 [1600x1200] So, now she can smile confidently and pain free. Composite-Build-up-12 [1600x1200]

Treating Fracture Tooth with Pulp Exposure

A 10 years old school-girl came to our clinic after she accidentally knocked her front tooth to the metal bar, causing two-third of her crown fractured and worse of all, the pulp of the tooth exposed.
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Two third of the crown of the upper left central incisor fractured

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The pulp of the tooth was exposed

We did an emergency root treatment over the tooth to reduce her pain.

Radiograph: Root canal treatment was completed

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The canal was sealed and ready for restoration

Root canal treatment (RCT) took 2 visits to be completed. After RCT, the tooth was ready for restoration. Before restoration, an impression was taken form her mouth. The fracture part of the tooth on the plaster model was build back with waxl. Then, a silicon impression was taken from the plaster model where it would be transfer back into patient’s mouth for restoration.
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Silicon impresion (purple) on the model

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The silicon impression was transferred into the mouth

During the restoration, resin composite was first build at the ‘side’ surface of the tooth (picture below). Then, the back surface of the tooth was built with composite resin with the help of the silicon impression (upper right picture).
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The side surface of the tooth was built first, with composite resin

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The side surface must have a good contact with the neighbour teeth

Later, the front surface of the tooth was placed with dentine shade/colour to mimic the natural dentine laver of a teeth (lower left picture).
Composite-Build-up-10 [1600x1200]Dentine shade of resin composite was placed a the front surface of the tooth Composite-Build-up-11 [1600x1200]Then, enamel shade was placed over the dentine shade
This followed by a layer of enamel shade which was placed on over the dentine shade to mimic the natural enamel layer of a tooth. Next, a opaque white shade composite resin was place a the edge of the teeth to mimic flourosis of a ‘young’ teeth. The edge of the tooth was grind to follow its neighbour teeth and finally, the tooth was polish to make it smooth and glossy!!
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Before treatment

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After treatment

We informed the patient that she might need a crown later as the latter is more durable!!

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