Aesthetic rehabilitation of upper central incisors using combined direct and indirect technique: A Case report


  • Mohd Haikal Muhamad Halil Department of Restorative Dentistry, Kulliyyah of Dentistry, International Islamic University, Kuantan, 25200 Pahang
  • Muhammad Hazwan Mustafa Astana Dental Clinic, Dataran Wangsa, Wangsa Maju, 53300 Kuala Lumpur
  • Syahirah Aisyah Kamaruzaman Kal Dental Clinic, Jalan Wangsa Delima 13, Wangsa Maju, 53300 Kuala Lumpur



aesthetic, composite, crown, e.max


Improving dental appearances generally leads to an increase in confidence, social interactions and ultimately quality of life. This case aimed to perform aesthetic rehabilitation on the upper central incisors. The patient was a 25-year-old female who was concerned with the gap in her front teeth and discolouration of her crown. The treatment started with shade matching and preliminary measurements prior to cementation of temporary crown. Later, an all ceramic e.max Lithium Disilicate crown was cemented on tooth 11 followed by direct composite restoration on tooth 21 for diastema closure. In conclusion, both the indirect and direct restorative technique when applied appropriately proved to be effective and satisfactory to the patient.


Abdullah, B., & Al-Tuhafi, A. (2006). Chief complaints of patients attending College of Dentistry at Mosul University. Al-Rafidain Dental Journal, 7(2), 201-205. Retrieved from

Andarabi, S., Zia, A., Kumar, A., & Alam, S. (2015). Closure of midline diastema by direct composite resin build-up using a customized matrix technique - a case report. International Journal of Oral Health Dentistry, 1(1), 46-49.

Anissa, BM., Chakroun, M., Hadyaoui, D., Nouira, Z., & Cherif, M. (2016). Zirconia based crowns for esthetic rehabilitation of severely discoloured teeth:a case report. Journal of Oral Health and Dental Science, 1(1), 1-3.

Azzaldeen, A., & Muhamad, A. (2015). Diastema closure with direct composite: architectural gingival contouring. Journal Of Advanced Medical and Dental Sciences Research, 3(1), 134-139.

Baia, J., Ortiz, M., Brandao, G., Pereiro Neto, A., Araujo, J., & SIlva, C. (2018). Multidisciplinary aesthetic rehabilitation: case report. Rio De Janeiro Dental Journal, 3(2), 37-41.

Chu, S., Devigus, A., Paravina, R., & Mieleszko, A. (2010). Fundamentals of Color (2nd ed.). Illinois: Quintessence Publishing Co.

Dolidze, T., & Bitarova, I. (2016). Advantages and disadvantages of e-max and zirconia crowns. European Scientific Journal, 12, 465-468.

Garg, N., & Garg, A. (2015). Textbook of Operative Dentistry (3rd ed.). Philadelphia: Jaypee Medical Inc.

Hwang, S., Ha, J., Jin, M., Kim, S., & Kim, Y. (2012). Diastema closure using direct bonding restorations combined with orthodontic treatment:a case report. Restorative Dentistry & Amp; Endodontics, 37(3), 165.

Jr, H., Sather, D., Jr, E., Cain, J., Mitchell, D., Blanco, L., & Kessler, J. (2020). Fundamentals of Fixed Prosthodontics (3rd ed.). Batavia: Quintessence Publishing Co.

Kusumasari, C., Hatayama, T., & Shimada, Y. (2021). Replacement of two failed indirect restorations with direct bonded restorations using minimally invasive strategy. Journal Of Dentistry Indonesia, 28(3).

Norbert, A., Farina, A., Linden, M., Colussi, P., Paranhos, L., & Carli, J. (2019). Aesthetic and functional rehabilitation of anterior teeth using the in-ceram zirconia system: a case report. Journal of Clinical and Diagnostic Research.

Nugroho, J., & Aco, A. (2020). Porcelain veneer for a simple and esthetic treatment on anterior teeth with enamel hypoplasia: a case report. Conservative Dentistry Journal, 9(2), 74-76.

Oteo, J. (2012). Additive solution to diastema closure by a combination of direct and indirect techniques. Dentistry, 02(03).

Peumans, M., Meerbeek, B., Lambrechts, P., & Vanherle, G. (1997). The 5-year clinical performance of direct composite additions to correct tooth form and position. Clinical Oral Investigations, 1(1), 12-18.

Pjetursson, B., Sailer, I., Zwahlen, M., & Hammerle, C. (2007). A systematic review of the survival and complication rates of all-ceramic and metalceramic reconstructions after an observation period of at least 3 years. Part I: single crowns. Clinical Oral Implants Research, 18, 73-85.

Prakash, L., Singh, M., Sarkar, M., & Kumar R, L. (2018). Application of CAD/CAM in esthetic rehabilitation using high translucent zirconia: a case series. International Journal of Contemporary Medical Research, 5(11), 4-7.

Rathi, S., & Verma, A. (2019). Material selection for single-tooth crown restorations. Applications Of Nanocomposite Materials in Dentistry, 225-235.

Ritter, A., Boushell, L., Walter, R., & Sturdevant, C. (2019). Sturdevant's Art and Science of Operative Dentistry (7th ed.). Missouri: Elsevier.

Nurulaqmar-Iwani, S. (2020). Review article: different types of coronal restoration for endodontically treated anterior teeth: treatment recommendation. International Journal Of Research Studies In Medical And Health Sciences, 5(8), 26-35.

Sowmya, K., Dwijendra, K., Pranitha, V., & Roy, K. (2017). Esthetic rehabilitation with direct composite veneering: a report of 2 cases. Case Reports in Dentistry, 2017, 1-3.




How to Cite

Muhamad Halil, M. H., Muhammad Hazwan Mustafa, & Syahirah Aisyah Kamaruzaman. (2022). Aesthetic rehabilitation of upper central incisors using combined direct and indirect technique: A Case report. IIUM Journal of Orofacial and Health Sciences, 3(2), 235–240.