Ex-vivo evaluation of direct additive composite restorations in orthodontically-treated patients

Objectives. In patients affected by dimensional discrepancy between size of anterior maxillary and mandibular teeth, orthodontic therapy could be necessary to solve occlusal problems. Frequently anterior restorations are indicated to finalize the aesthetic aspect of orthodontic treatment, such as diastema; peg-shaped or cone-shaped teeth; agenesis or amelogenesis imperfecta; alterations in shape and color; or asymmetry in the composition of the smile. The aim of this retrospective clinical study was to evaluate the long-term clinical behavior of additive direct restorations performed on anterior healthy teeth with resin composite materials to correct anterior teeth discrepancies persisting after orthodontic treatment and to access marginal quality under a SEM using epoxy replicas. Methods. For this study, patients with dimensional teeth discrepancy who received additive composite restorations in anterior maxillary teeth after an orthodontic treatment, between January 2009 and January 2016, were selected. Patients were recalled and divided in two groups according to the restoration performed: G1) diastema closure; G2) tooth shape modification. Conclusions. Based on the obtained results, direct composite restorations in the treatment of diastemas or shape modification in anterior teeth showed a good or very good long-term clinical performance associated with a satisfying aesthetic and complete conservative procedures.