Anterior esthetic rehabilitation with composite resin: case report of a 6-year follow-up in a patient with hypoplasia and diastemas

ABSTRACT Given the growing popularity of invasive techniques in Esthetic Dentistry, it is essential to emphasize conservative approaches capable of achieving effective esthetic and functional outcomes while preserving healthy dental tissues. The objective of this study is to report a clinical case with a six-year follow-up in which esthetic smile remodeling was performed using direct composite resin restorations in a patient presenting enamel hypoplasia associated with anterior diastemas. A 18-year-old female patient sought care complaining about tooth discoloration and interdental spacing. Clinical examination revealed enamel hypoplasia on the anterior teeth of both arches, diastemas between the central incisors and between the lateral incisors and canines, as well as a deficient Class IV restoration on tooth 22. The treatment plan included combined dental bleaching (in-office and at-home) followed by esthetic remodeling using nanoparticulate composite resin (Z350XT, Solventum). To ensure predictability and control of dental contour, a silicone guide was fabricated based on a diagnostic wax-up. After six years of clinical follow-up, the restorations remained esthetically stable, with preserved marginal integrity, and no signs of fractures or staining. It is concluded that the combination of bleaching and direct composite resin restorations proved to be a conservative, efficient, and predictable approach for the simultaneous treatment of enamel hypoplasia and diastemas.