Natural restoration

A male patient in his early twenties was self-conscious when he smiled due to the relatively small size of his upper right lateral incisor. He had a history of enamel hypoplasia affecting some of his dentition.

The initial consultation to evaluate the aesthetics of the patient’s smile revealed the upper right lateral incisor was also mesially inclined. The incisal edge of the upper right central incisor was slightly shorter than its contralateral counterpart. The gingival levels of the two lateral incisors were different and the gingival aesthetic line classification was class 1.

Lateral incisors are rarely symmetrical in nature. In this case the patient was not happy with the variation in form and width of the upper right lateral incisor. The space available for increasing the length of this tooth was very tight.

I discussed the treatment options with the patient and made him aware of all the factors mentioned above. He, nevertheless, only wished to proceed with the build-up of the upper right lateral incisor. He understood that slight re-contouring of the lower right canine would be required to accommodate the increase in length. The incisor was built up using thin layers of Heraeus Venus Pearl composite in the step-by-step process described below. I chose Venus Pearl on the basis of its aesthetics, strength and ease of application.