Inverted Layering Technique as a Biomimetic Procedure in a Multidisciplinary Resolution of Discolored Teeth: A Case Report.

Jefferson Pires da Silva Júnior, Pedro Paulo Lopes de Almeida, Felipe Nogueira Anacleto, Lucas Alves Moura, Sérgio Eduardo de Paiva Gonçalves, Marcelo Figueiredo Lobato
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Abstract

The objective of this work is to report a restorative approach with composite resin applied in reverse in the aesthetic resolution of darkened anterior teeth. A 27-year-old female patient presented with the main complaint of dissatisfaction with the aesthetics of her smile due to dental darkening, a result of childhood trauma, without painful symptoms, pathological clinical signs or change in care. In the intraoral examination, a darkening of teeth 11 and 21 was observed, which radiographically showed thickening of the periodontal ligament, with disharmonious configuration of the marginal gingiva. From the clinical and radiographic characteristics, we opted for periodontal intervention for recovery and gingival levelling, followed by endodontic intervention and aesthetic restorative restoration. The restorative step was carried out sequentially by internal tooth bleaching, removal of dentin still pigmented after bleaching and enamel preservation. Soon after, it was restored in an alternative way and layered using a technique called reverse, using strips of polyethylene fiber over the dentin resin. The technique preserved the remaining enamel with the maintenance of the original remaining guides, proving to be a viable conservative alternative since of the diagnosis to the restorative conclusion in view of the longitudinal confirmation of the restorative efficacy after 1 year.

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倒置分层技术作为一种仿生程序,在多学科治疗中解决牙齿变色问题:病例报告。
这项工作的目的是报告一种反向应用复合树脂的修复方法,从美学角度解决前牙变黑的问题。一位 27 岁的女患者主诉因童年创伤导致的牙齿变黑而对笑容的美观感到不满,但没有疼痛症状、病理临床表现或护理改变。口腔内检查发现,11 号和 21 号牙齿颜色变深,X 光片显示牙周韧带增厚,边缘牙龈结构不协调。根据临床和影像学特征,我们选择进行牙周干预以恢复牙周和牙龈平整,然后进行牙髓干预和美学修复。修复步骤是按顺序进行的,包括牙齿内部漂白、去除漂白后仍有色素的牙本质和保留釉质。不久后,采用另一种方式进行修复,在牙本质树脂上使用聚乙烯纤维条进行分层。该技术保留了剩余的珐琅质,并保持了原有的剩余导板,从诊断到一年后修复效果的纵向确认,该技术被证明是一种可行的保守替代方法。
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