Smile modification in odontopediatrics: minimal invasive aesthetic solution for a complex case

Clinical case's description: A 15-year-old female patient institutionalized in a foster care went to the Dental Clinic of the University UCP-Viseu, under the "Pequenos Grandes Sorrisos" social program referring a discomfort in the 2nd quadrant. At the oral examination, agenesis of the teeth 1.2 and 2.2 was observed, with the permanence of 6.3 and a marked deviation of the upper dental middle line to the right. After extracting the 63 (urgency), a tooth that caused the discomfort, a treatment plan was drawn up. The ideal treatment would pass through a bi-maxillary orthodontic treatment. The patient's personal history and her particularities, that hypothesis had to be excluded. Was then proposed to perform a coronoplasty of the canines and increase of the central incisors. For planning were performed: photographic status, study models, and occlusal recording (Oclufast, Zhermack, Germany). Afterward was done a Digital Smile Design and sent to the laboratory for the diagnostic waxing. The mock-up allowed an aesthetic and functional evaluation. The restorations were done with composite resin (SynergieD6, Coltène, Switzerland) were performed, with the support of a transparent silicone mold (RegistradoClear, VOCO, Germany). Discussion: Orthodontic treatment would last at least two years. The patient is temporarily institutionalized and was looking for a quick and economical solution. Coronoplasties with individualized mock-ups can quickly solve some of the questions, particularly in the field of aesthetics in Pediatric Dentistry. Conclusion: The treatment plan must be molded to each patient. The limitations that he/she presents must be a motivation according to factor for solutions that meet the patient's objectives.