A 31-year-old patient presented for aesthetic improvement after uncomplicated trauma to her maxillary and mandibular incisors. The initial clinical visit included photographic documentation and intra-oral scanning (Figs. 1 & 2).

Treatment plan

The proposed treatment plan involved direct composite restorations as the least invasive and most predictable treatment option. The patient accepted the proposed plan, and the treatment team proceeded with digital planning of the restorations (Fig. 3). Models based on the proposed design were printed, and a silicone index was produced.

At the subsequent clinical visit, shade selection was performed using the composite button technique (Fig. 4). The A1 enamel and dentine shades of CLEARFIL MAJESTY ES-2 Premium (Kuraray Noritake Dental) were selected.

Clinical procedure

Local anaesthesia was administered, and the operative field was isolated using a dental dam (Fig. 5). A smooth bevel was created using diamond burs, an Arkansas stone and 3M Sof-Lex discs (Solventum; Figs. 6–8). The treated tooth surfaces were sand-blasted and etched with phosphoric acid, and the adjacent teeth were protected with a metal strip. The two-step self-etch adhesive CLEARFIL SE BOND 2 was applied.

The silicone index was filled with CLEARFIL MAJESTY ES-2 Premium (Shade A1E) and inserted to build up the palatal shell of the restorations (Figs. 9 & 10). The proximal walls were restored using matrices (Garrison Dental Solutions) and CLEARFIL MAJESTY ES Flow (Shade A1; Fig. 11). The internal anatomy of the restorations was recreated using CLEARFIL MAJESTY ES-2 Premium (Shade A1D; Figs. 12 & 13).

The Clear effect shade was used to mimic the natural translucency of the incisal edges (Fig. 14). The halo effect was reproduced using Shade A1D (Fig. 15), and layering was completed with Shade A1E (Figs. 16–18). The restorations were then finished and polished (Figs. 19 & 20).

Treatment outcome

The patient was satisfied with the result (Fig. 21). The restorations were virtually indistinguishable from the natural tooth structure, featuring a smooth transition from tooth structure to composite and natural incisal effects. The surface texture also contributed to a natural appearance (Figs. 22a & b). As the patient was satisfied with the procedure and outcome, the mandibular incisors were restored in the same way (Fig. 23).

Conclusion

The case has demonstrated that modern adhesive dentistry enables predictable and minimally invasive procedures that deliver rapid and true-to-life results. The CLEARFIL MAJESTY ES-2 Premium system offers a wide range of shades and translucencies, allowing clinicians to achieve seamless outcomes using a polychromatic layering technique.