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Special Issues
July/August 2023
Volume 44, Issue 1
Peer-Reviewed

Smiles Matter at Any Age

Robert Rosenfeld, DDS

Population trends show a steady increase in the senior population. Perhaps unlike generations past, many of today's seniors remain fashion conscious and strive to maintain a youthful appearance through the use of myriad products and procedures. Not surprisingly, this includes addressing one of the most important features of one's appearance: his or her smile. Not every patient has the wherewithal to afford expensive indirect dental procedures, such as veneers or crowns, nor does every patient have the constitution to undergo lengthy and involved procedures. Direct composite restorations, however, executed skillfully, may satisfy the esthetic desires of most patients. Until recently, for even routine dental restorations, clinicians needed to stock an extensive array of composite resin materials to match the often darker shades of seniors' teeth and spend considerable time blending shades or adding tints to create esthetic restorations that match the surrounding tooth structure. The advent of single-shade composites like OMNICHROMA® One-Shade Universal Composite (Tokuyama, https://omnichroma.com/us/), which, when polymerized, is capable of mimicking the appearance of almost any tooth in which it is placed, has simplified the clinician's job. OMNICHROMA allows clinicians to provide their senior patients affordable and esthetic solutions, as demonstrated in the two cases presented.

Key Takeaways

The use of OMNICHROMA single-shade composite resin allows clinicians to match virtually all shades of teeth, even those darker than the VITA classical shades (often needed for seniors).

Using a single-shade system of composites allows for a reduced inventory of shades and translucencies needed to match all teeth and lessens the complexity of shade selection, making restorations speedier and more efficient.

Even complicated characterization may be possible with the use of a single-shade composite system like OMNICHROMA.


About the Author
Robert Rosenfeld, DDS
Private Practice, Westwood, New Jersey; Fellow, International Academy of Dental Facial Esthetics

Fig 1. (Case 1) An 86-year-old woman had long been aware of a fracture line in tooth No. 8 but was concerned that it may “splinter” if an attempt were made to repair it. Finally, she mustered the courage to have it treated.

Figure 1

Fig 2. The VITA shade (VITA North America) that most closely matched the tooth was D3, but when a small sample of D3 composite material was polymerized, its match to the tooth was unsatisfactory.

Figure 2

Fig 3. Preparation of the tooth revealed deeply colored but noncarious dentin.

Figure 3

Fig 4. Enamel was acid-etched.

Figure 4

Fig 5. Placement of OMNICHROMA One-Shade Universal Composite. Prior to polymerization, the material appeared opaque and far too light in shade.

Figure 5

Fig 6. After polymerization, finishing, and polishing, the shade of the OMNICHROMA restoration blended seamlessly with its surroundings. Trusting the material to make the shade match proved worthwhile.

Figure 6

Fig 7. (Case 2) A 66-year-old man presented with a carious lesion on the distofacial cervical aspect of tooth No. 8. A very dark root surface and unusual pattern of characterization of enamel was present.

Figure 7

Fig 8. Tissue was retracted with #000 cord (Ultrapak™, Ultradent) and preparation completed. Preparation extended from the extremely dark root surface into much lighter enamel, over very dark dentin.

Figure 8

Fig 9. A Mylar strip was used to protect the adjacent tooth while selective etching of enamel was accomplished.

Figure 9

Fig 10. After placement of a small amount of OMNICHROMA Flow for good adaptation to the cavity, OMNICHROMA material was placed. Unpolymerized, it bore no resemblance to the shades of the nearby tooth structure.

Figure 10

Fig 11. Before trimming, the polymerized OMNICHROMA material already showed adaptation to the shade of the root at the most cervical region, as well as to the lighter enamel at the more incisal extent.

Figure 11

Fig 12 and Fig 13. After finishing and polishing, the OMNICHROMA material demonstrated its ability to match its surroundings, even though they ranged from light to dark in the same tooth.

Figure 12

Fig 12 and Fig 13. After finishing and polishing, the OMNICHROMA material demonstrated its ability to match its surroundings, even though they ranged from light to dark in the same tooth.

Figure 13

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