MiCD Clinical Techniques
Discover BioLogically Beautiful Restorations
MiCD GN aims to provide educational resources to help dentists embrace the MiCD concept and treatment protocols in routine clinical practice.
Case prepared by Dr. Sushil Koirala (NP)
Discoloured Tooth
A male patient aged 23 presented with a severely discoloured central incisor (#21). The tooth was root canal treated 13 years ago. The discoloured tooth was the only complaint of the patient. After thorough examination internal bleaching was suggested but the patient preferred a direct veneer restoration due to immediate results. Achieving proper tooth colour, texture, incisal translucency, gingival shape and zenith were the main clinical challenges in this case.
Figure 1
Discoloured non-vital tooth #21 with asymmetry of gingival shape.
Figure 2
After placing a comestic veneer and gingival contouring.
Figure 3.
Figure 4
Gingiva is retracted with a periodontal pack for 2 days.
Figure 5
Gingiva after removal of periodontal pack.
Figure 6
Isolate the tooth with gingival retraction cord and prepare marginal groove with Diamond Point #340S.
Figure 7
Prepare depth orientation grooves with Diamond Point #121.
Figure 8
The enamel frame is preserved to increase retention of the veneer.
Figure 9
Etch the enamel with phosphoric acid.
Figure 10
Place a metal strip during application of bonding agent.
Figure 11
Mask the dark dentin with a universal shade of flowable opaquer.
Figure 12
Build-up the dentin (#A2) and enamel (#INC) layers incrementally.
Figure 13
Restoration after gross finishing.
Figure 14
Check surface texture with articulating paper.
Figure 15.
Note the prominent textures on tooth #11.
Figure 16
Create similar surface texture on tooth #21 with OneGloss #IC.
Figure 17
Achieve similar texture as tooth #11.
Figure 18.
After restoration, note the colour, gingival shape and texture of tooth #21.
Preserving Health, Enhancing Smiles
Minimally Invasive Cosmetic Dentistry
(MiCD) is a holistic patient-centric treatment approach
