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)
Anterior Fracture
A Young 14 year old boy complained of a broken anterior tooth. After thorough examination, the fractured tooth #11 was root canal treated and two restorative options were given to his parents. Ideally metal free indirect crown or veneer would be suitable. However they preferred a direct cosmetic veneer after evaluating the cost and considering his age. The clinical challenges in this case were retention, shade selection, achieving the mamelon effect and surface texture. A long bevel tooth preparation design was used to enhance the retention and the flowable frame technique with Beautifil Flow #A3T was used to obtain the natural contour and depth of shade.
Figure 1
Root canal treated, fractured tooth #11.
Figure 2
Tooth #11 & 21 restored with direct cosmetic veneers.
Figure 3
Figure 4
Isolate tooth #11 with gingival retraction cord and mark the area of tooth preparation.
Figure 5
Minimal tooth reduction is sufficient for direct veneer restorations.
Figure 6
Etch the enamel surface with phosphoric acid.
Figure 7
Etched enamel surface with a frosted appearance.
Figure 8
Place a plastic strip before creating the flowable frame.
Figure 9
Apply bonding agent, light-cure and inject flowable resin (#A3O) at fracture junction.
Figure 10
Apply flowable resin (#A3T) to create the incisal third of the frame.
Figure 11
Build-up the mamelon structure with dentin (#A2) as seen on natural teeth.
Figure 12
Build-up the dentin layer (#A2) and enamel layer (#INC).
Figure 13
Note the different degrees of opacity and translucency.
Figure 14
Create three distinct lobes to achieve the mamelon effect.
Figure 15
Contour and finish the restoration.
Figure 16
Remove the gingival retraction cord.
Figure 17
Restored tooth #11 after final polish.
Figure 18.
The patient’s smile is restored with direct cosmetic restoration.
Preserving Health, Enhancing Smiles
Minimally Invasive Cosmetic Dentistry
(MiCD) is a holistic patient-centric treatment approach
