The composite injection technique is a new, minimally invasive method to reconstructe teeth in an aesthetic way. The method was refined and perfected by Dr David Gestakovski, Zagreb.
Article and Pictures with friendly courtesy of Dr David Gestakovski
The technique is purely additive, i.e. the teeth are not at all damaged. Only additional material is applied. It is minimally invasive and can be done without grinding the teeth. The new form of the teeth is transferred added by the help of a transparent silicone mould and a flowable composite. Thus the previously planned shape of the teeth is definitely transferred from the planning model to the teeth, which are then finished and polished. Procedure: First, photos of the patient and impressions of the teeth are taken. These photos serve as planning documents. The shape and size of the teeth are now designed digitally with the help of special programmes (i.e.Smile Designer). Once the new, desired appearance has been determined, this template is transferred to a model in wax. This is called a Wax-up. Thereafteren , a silicone mould is pulled over this Wwax-up . The space between the tooth and the silicone mould (where the wax-up was) is filled with the flowable composite to build up the desired shape and form . However, before the final reconstruction is injected and bonded, a trial run is made with a classic temporary resin. The appearance of the "new" teeth can be assessed in the patient's mouth. This is called a Mock-up. The Mock-up can be easily changed and adjusted according to the patient's wishes and needs. Only when the shape and size fit, only once the overall result, pleases the patient and meet aesthetic as well as functional requirements, everything is prepared for the actual reconstrution. A flowable composite (a filling resin) is used for this purpose, which is adhesively cemented, analogous to the classic composite filling technique. This innovative method is an interesting alternative for patients who do not want complex, expensive and invasive ceramic facets (veneers). The durability of this composite reconstruction is estimated to be about the same as that of a well- placed composite filling, i.e.. aApproximately 8-10 years. The advantage of composite over ceramic is that composite can be easily repaired and supplemented, if necessary. In addition, the reconstructions can - if desired - always be polished during up at the future check-up appointments. Depending on the effort involved, the cost of this new technique is about half that of a ceramic veneer.
Picture1. Digital smile design.
Respecting the proportions of the teeth and face. Picture 1 Smile Design, digital reconstruction© David Gestakovsking
Picture 2. Wax-up, wax simulation of the later composite build-up
Picture 2 Wax Up on a model, showing the tooth shape and later surface texture as a template for the moulds © David Gestakovski
Picture 3. Silicone Model for the so- called Mock-up.First try-in and test run in the patient's mouth.
Picture 3. Silicone key for the trial implementation of the wax-up in the patient's mouth, a trial run to check the shape of the teeth in the mouth © David Gestakovski
Picture 4 . Mock- Up. The shape and size of the teeth are probatorilytentatively inserted with temporary resin to allow formake any necessary changes.
Picture 4 The Mock- up, the probatory implementation of the planning. Assessment of tooth shape and size in the patient'’s mouth, © D. Gestakovski
Picture 5. Injection, transparent silicone mould with injection channels to perform the definitive reconstruction.
Picture 5 ,transparent silicone key with injection channels for the flowable composite Copyright D. Gestakovski
Picture 6. Reconstruction, after injection before finishing and polishing. Picture 6 after injection , before finishing and polish
Finished and polished reconstruction, (c) David Gestakovski
Article and Pictures with friendly courtesy of Dr David Gestakovski, June 2022