Many people are dissatisfied with the aesthetics of their front teeth, perhaps due to discoloration, attrition, fractures, misalignment, or gaps between them (diastemas).
Most people who seek treatment for diastemas do so for cosmetic concerns and potential effects on speech, usually through the direct-bonding restoration technique as the preferred cosmetic treatment.
Generally, any aesthetic improvement of healthy teeth should be non-invasive, or at least minimally invasive. While indirect restorative options often require preparation that involves potential destruction of healthy tooth structure, such as with laminate veneers or crowns, direct techniques such as direct composite resin and orthodontic treatment often strive to balance need, risk, and damage.
Dental bonding is a particularly attractive treatment option because it preserves tooth structure, restores function and aesthetics, and can be completed in a single clinical visit. It is also painless, cost-effective, and the need for more complex indirect restorations can be delayed.
That said, the successful implementation of direct-bonding restorations requires excellent clinical skills by a professional dentist.
Direct resin bonding for front teeth diastema
Direct composite resin restorations, which are tooth-shaped fillings made of a special material, are becoming more popular in dental practice, especially for healthy teeth that require aesthetic correction while preserving as much natural tooth structure as possible.
Studies have reported excellent long-term results, with durability of 5 to 10 years being expected for bonding restorations. A study by Peumans et al. found a 5-year survival rate of 89% for 87 restorations in 23 patients, although some restorations had to be replaced due to changes in shape and color.
Requirements for successful tooth bonding for gaps
When applying direct composite resin buildups to restore teeth, there are certain objectives that dental professionals aim to achieve. These objectives include:
- Ensuring that the color, shade, and appearance of the composite material closely match the natural tooth
- Establishing proper contacts with neighboring teeth
- Avoiding trauma to the gums
- Improving the overall appearance of the treated teeth, and
- Maximizing the longevity of the restorations
Characteristics of dental bonding for diastema
Both patients and dentists benefit from direct composite resin restorations for several reasons:
1. Immediate correction
Bonding allow for the correction of tooth size, shape, color, and position in a single treatment session.
The process involves the following steps:
- Examination and Evaluation: The dentist will examine the diastema and evaluate its size, position, and overall condition of the teeth involved.
- Shade Selection: The dentist will determine the appropriate shade of composite resin material to match the natural color of the teeth.
- Tooth Preparation (if necessary): If there are any alignment issues or irregularities in the teeth, minor tooth preparation may be performed to create proper arch form and alignment. The dentist may roughen the surface of the teeth before applying the bonding material.
- Bonding Procedure: The dentist will apply a bonding agent directly to the tooth surface and then carefully apply layers of composite resin material to fill the gap and shape the teeth. The resin is sculpted and shaped to achieve a natural appearance.
- Curing: Each layer of composite resin is hardened using a special light, known as a curing light. This helps the material to set and bond to the tooth structure.
- Finishing and Polishing: Once the resin has hardened, the dentist will trim and shape the restoration to achieve the desired contour and appearance. The restoration is then polished to make it smooth and blend with the natural teeth.
- Bite Adjustment: The dentist will ensure that the bite feels comfortable and that the restored teeth come together properly when biting and chewing.
Bonding for diastema offers a conservative and relatively quick solution to close the gap between teeth, providing improved aesthetics and a natural-looking smile.
2. Non-invasive or minimally invasive
The technique used for direct composite resin restorations is either non-invasive or requires minimal tooth preparation. In a study examining various parameters related to aesthetic appearance, functional performance, and oral health related to bonding, the aesthetic parameters showed excellent clinical results in a significant percentage of cases, although some decrease in surface lustre was observed over time.
The study also found that the fit of the restoration at the edges of the tooth (marginal adaptation), the contact between the restored tooth and its neighboring teeth (proximal contact), and the health of the gums and surrounding tissues (periodontal response and adjacent mucosa) were generally considered to be very good.
The use of direct composite resin buildups for closing gaps between teeth, reshaping teeth, or changing tooth color is reported to have promising results, being strong and durable while accurately simulating the appearance of natural teeth. But if necessary, the restorations can be removed, and the teeth can be returned to their original state.
In case of minor failures, the restorations can be easily repaired. The most common failures observed in patients who have undergone bonding restoration are fractures or chipping of the composite resin, with fewer incidences of color mismatches and marginal gaps. In most cases, the restorations can be repaired. In fact, the flexibility of composite resin restorations allows for instant repairs and changes in shape or color, even after long periods of use.
5. Alternative treatment options
In case of major failures or loss of the restoration, various other treatment options such as laminate veneers or crowns can be applied.
If the diastema (gap) between the teeth is small and the adjacent teeth are in good condition, the dentist may only focus on bonding and restoring the tooth or teeth involved in the gap.
However, if there are other concerns with the adjacent teeth, such as issues with their shape, color, or alignment, the dentist may recommend restoring those teeth as well to achieve a more harmonious and aesthetically pleasing result. This could involve bonding or other restorative techniques, such as veneers, to improve the appearance of the adjacent teeth and create a more balanced smile.
Moreover, if the gap is too large to be effectively closed with bonding alone, alternative options may be recommended, such as orthodontic treatment (braces or aligners) or more extensive restorative procedures like dental veneers or crowns. These options can help address larger gaps and provide more comprehensive and long-lasting results.
Direct bonding for diastema is often considered cost-effective compared to alternative treatments for several reasons:
- Minimal tooth preparation: Dental bonding typically requires minimal preparation of the natural teeth, avoiding the need for extensive tooth reduction or removal. This means there is less time involved in the procedure and less expense associated with tooth preparation.
- Single visit procedure: Bonding can often be completed in a single dental visit. This eliminates the need for multiple appointments and reduces the overall cost of treatment. Alternative treatments, such as dental veneers or orthodontic procedures, may require multiple visits and additional expenses.
- No laboratory work: Bonding is performed directly by the dentist using composite resin material, which can be shaped and molded to the desired result. This eliminates the need for custom-made restorations from a dental laboratory, which can significantly reduce costs compared to alternatives like veneers or crowns that require laboratory fabrication.
- Affordable material: The composite resin material used for bonding is generally less expensive than the materials used for veneers or crowns.
- Reversibility: If a person wishes to pursue alternative treatments in the future, such as veneers or orthodontics, the bonded material can be easily removed without causing significant damage or expense.
Does bonding require anesthesia?
The use of anesthesia during tooth bonding for diastema depends on the individual patient and the extent of the procedure. In some cases, the procedure may not require anesthesia if it involves minimal tooth preparation and the patient does not experience discomfort. However, if the dentist needs to remove any tooth structure or if the patient has sensitivity or anxiety, local anesthesia may be administered to ensure a pain-free experience.
Why is direct composite bonding popular for diastema?
Direct composite resin buildups can meet the objectives of superior aesthetics, adequate contacts, preservation of periodontal health, improved appearance, and satisfactory longevity when state-of-the-art clinical techniques are applied.
How long does tooth bonding for diastema take?
The duration of the restoration procedure depends on several factors, including the complexity of the case, the number of teeth involved, and the skill of the dentist. In general, the procedure can typically be completed in a single dental visit, which may last around 1 to 2 hours.
Final thoughts: why choose bonding for diastema?
Direct bonding with composite resin is a relatively quick and cost-effective treatment option compared to alternatives like orthodontic treatment or indirect restorations such as veneers or crowns.
If the patient is not satisfied with the outcome, the restoration can be easily removed without causing damage to the tooth structure. Additionally, composite resins come in various shades, allowing for precise color matching and a discreet treatment result.
Overall, diastema closure using direct bonding of composite resin offers a conservative and aesthetic solution for patients seeking to improve the appearance of their smile. The procedure is efficient, cost-effective, and customizable to meet individual patient needs.