Lithium disilicate fragment to restore anterior enamel hypoplasia: a conservative approach with 6-year follow-up

Objective: The case reports 6-year follow-up of a lithium disilicate fragment luted on buccal surface of the right upper central incisor to restore an enamel hypoplasia lesion. Method: First, the tooth was whitened using at-home vital bleaching (i.e., daily use of 20% carbamide peroxide gel for 15 days) and enamel microabrasion using 6% hydrochloric acid in 5 cycles of 10 s each. The whitening techniques reduced the extension of the lesion, although without solving the unesthetic issue. Thus, a minimally invasive preparation on the remaining hypoplasia was carried out for partial restoration of the buccal surface with a glassy ceramic fragment reinforced by lithium disilicate IPS e.max Press. Results: The immediate clinical result showed that home bleaching added to microabrasion contributed to standardize the color of the hypoplastic enamel surface and to reduce the size of the opacity generated by hypoplasia. This allowed restoring the aesthetics and, consequently, the patient’s self-esteem, using a minimally invasive technique, with preparations confined to the enamel for adhesion of the ceramic fragment. Conclusion: After 6-years, the functional and aesthetic result of this treatment remained satisfactory and without structural and optical clinical changes associated with the adhered fragment.