A 42-year-old female patient presented for the replacement of aging composite restorations and aesthetic enhancement of her smile. By employing a minimally invasive direct composite bonding technique, the diastemas in both the maxillary and mandibular anterior regions were closed while ensuring a natural and balanced aesthetic result.
Introduction
Anterior diastemas are prevalent clinical findings that can adversely affect a patient’s smile harmony and self-confidence. While treatment modalities range from orthodontics to indirect ceramic veneers, direct composite bonding offers a conservative, cost-efficient, and immediate alternative. Nevertheless, achieving predictable functional and aesthetic success with this method necessitates meticulous planning and advanced clinical proficiency.
This case report details the clinical steps involved in replacing failing restorations and the aesthetic rehabilitation of the anterior segment using a direct composite approach.
Case Description
A 42-year-old patient traveled to Albania for a three-day period tore place old composite bondings on her upper central incisors and the lower intercanine sector. The patient’s main concern was the aesthetic management of wide anterior diastemas.
We discussed three primary treatment options:
Indirect Restorations: Zirconia or lithium disilicate veneers.
Orthodontics: To close spaces through tooth movement.
Direct Bonding: A minimally invasive, cost-effective, and rapid solution.
The patient was informed of the risks associated with bonding, including potential staining and lower mechanical strength. It was also noted that diastema closure would result in wider tooth morphology. After evaluating these factors, the patient chose the direct bonding protocol.
Diagnosis and Initial Phase
On day one, we performed a full medical/dental history and a digital panoramic X-ray. After capturing baseline clinical photographs (Figure 1), the old composite material was carefully removed.
Figure 1. Initial presentation showing old composite restorations
before removal
Following the removal of the old material, the natural teeth were photographed (Figure 2). Definitive impressions of the maxillary and mandibular arches were then taken using a two-stage polyvinylsiloxane technique (putty + light-body).
Figure 2. Natural teeth post-removal of old restorations.
Laboratory Phase
Impressions were sent to The Lab Perfect Dent for a digital diagnostic wax-up. The plan focused on achieving a harmonious balance between reducing the diastemas and maintaining anatomical proportions, per the patient’s request for a natural look with no shade change.
Clinical Preparation
A professional cleaning and interproximal stripping were performed on day two to remove all surface stains. Professional whitening was intentionally bypassed to maintain the patient’s preferred natural shade.
Aesthetic Execution
The patient approved the wax-up for teeth 11, 21,43, 42, 41, 31, and 32. Maxillary and mandibular silicone keys were fabricated by the lab to serve as a guide for the direct bonding procedure.
Figure 3. Digital diagnostic wax-up.
Restorative Phase
Direct bonding was performed on day two using anano-hybrid composite (Olident Olirevo). Restorations were applied to the vestibulo-mesial aspects of teeth 11 and 21, and the mesial, distal, and vestibular surfaces of teeth 43 through 32.
The silicone keys ensured the faithful reproduction of the planned wax-up. A layering approach was used to control translucency,utilizing an OA2 interproximal shade and an A2 superficial shade for seamless aesthetic blending. The composite was finished and polished using diamond burs and discs, with special care taken to remove cervical overhangs and maintain a smooth transition to the natural tooth structure.
Completion and Post-Operative Care
On day three, a final polishing session addressed the lingual and palatal contours, ensuring perfectly smooth interfaces. After capturing the final clinical photographs, the patient was educated on proper brushing and flossing techniques to maximize the longevity of the bonding and prevent future gingival inflammation.
Figure 4. Final clinical result.
Results and Conclusion
The treatment successfully addressed the anterior diastemas, enhancing the overall balance of the smile while maintaining a natural look. Both the aesthetic and functional goals were met, with the patient expressing full satisfaction with the final result.
This case confirms that direct composite restorations represent a reliable, conservative alternative for aesthetic rehabilitation in the anterior segment when proper clinical protocols are followed.
Figure 5. Before and after comparison: Pre-treatment smile (left) versus the definitive aesthetic
result following direct composite bonding (right).
Price:
Diastema Closure with Direct Composite Bonding EUR €2,000 (for 20 teeth) Book Now!
Price Includes:
- Airport Transfers
- Hotel–Clinic Transfers
- Accommodation (clinic’s choice)
*Click here If you prefer before buying package to Start Conversation with Hospital
Author & Surgeon: Dr. Maurizio Procaccini, DT
Date Posted: April 15, 2026 at 09:54 UTC
Last Update: April 28, 2026 at 10:38 UTC
Scanned original that contains the doctor stamp and signature