Trauma with accompanying fracture ofa permanent incisor is a terrible experience for the young patient and createsa psychological impact on both the parents and children.2 If theinjury involves the loss of extensive tooth structure, it alters the child’sappearance and makes him the target for teasing by peers.Treatment objectives may varydepending on the age of the patient, socioeconomic status of the patient andintraoral status at the time of treatment planning.
7 There arevarious treatment modalities for restoration of fractured teeth like compositerestoration, fixed prosthesis, reattachment of the fracture fragment (ifavailable) followed by post and core supported restorations.7-9Common restorative management such as full-coverage restoration or laminate veneers can be considered aftermultiple fragment rebonding/ composite resin restorations have been done andthis option is no longer functional. These methods might tend to sacrifice thehealthy tooth structure and challenge the dental professional to match with theadjacent healthy teeth. 10Management of the young patient withanterior tooth fracture provides a great challenge to the dental professionalboth from an aesthetic and functional perceptive. The predictable estheticrestoration of the broken incisal edge of maxillary incisors is a demanding andtechnique sensitive procedure. Its success is dependent on clinician skills andknowledge and also on adhering to a systematic and problem-solving approach.6A logical method is used to build-up morphologically correct compositerestorations by careful selection of composite shades, tints and opaquers inaccurate combinations, an illusion of varying translucencies and opacitiesbecome visible over natural tooth structure.11These anterior composite restorativematerials offer a cost-effective management alternative among young adults withfractured dentition, where esthetics is a major concern.
With furtherimprovements in bonding chemistry, the success rate of composites is speculatedto improve.9 A good polishing system including polishing paste,cups and wheels is recommended to achieve appropriate luster. In the present case, an innovativetechnique which includes both direct and indirect method of restoring was designedby using polyvinyl siloxane rubber base impression material (putty) as atemplate. This method is simple, quick and economic, when compared to otherinvasive procedures. The usage of the polyvinyl siloxane rubber template offersincremental layering of the composite restorative material, optimal depth ofcuring, accurate reproducibility of the morophological contours and minimalpolishing and finishing procedures.12,13