Flow injection technique for conservative esthetic rehabilitation in a young ectodermal dysplasia patient

Aim: The flow injection technique (FIT) has emerged as a minimally invasive solution for esthetic dental rehabilitation. Although not suitable for all cases, it can be effectively applied in selected conditions. We aimed to present a conservative smile restoration in a young patient (17yo) with ectodermal dysplasia, demonstrating its potential in managing microdontia and hypodontia-related esthetic challenges. The chief compliance of the patient with economic difficulties, was to find a provisional solution to close the diastemas affecting the deciduous and conoid teeth (teeth 62-63-52). Methods: A 17 years old male patient attended the Dental Clinic of the University of Bologna with smile defects due to ectodermal dysplasia. The patient complain the estehtic of the smile but also economic difficulties. Clinically, the agenesis of the upper right lateral incisor was observed, along with diastema between central incisors, conoid teeth and presence of mobile deciduous teeth (53, 62, 63). After medical and dental records, rx, photos and videos, digital scans were taken (TRIOS 5). A provisional solution with FIT was proposed. After obtaining the informed consent, a diagnostic wax-up was requested to the dental technician. Following the mock-up trial, an indirect transparent silicone mould was performed (Zhermack SpA) and for each tooth a whole was created. The teeth were isolated and sandblasted with 50 µm alumina powder, etched (37% H3PO4) and 3-step adhesive was applied. The teeth were isolated with Teflon tape one-by-one, the silicone mould was positioned and an highly-filled flow resin composite (CLEARFIL MAJESTY™ ES Flow – Low, Kuraray Noritake (shade A1) was injected. Light-curing (20s) was performed through the mould and after its removal. Finally, the restorations were finished (Twist Dia, Kuraray). Final polishing was performed after 1 week. Results:. The patient reported high satisfaction with the esthetic outcome and experienced no postoperative symptoms or complications. At the 3 months follow-up the restorations were perfect with no sign of wear, fractures or periodontal problems. Conclusions: The flow injection technique allowed for a predictable and efficient esthetic rehabilitation of the altered smile in a single appointment. A thorough understanding of the materials and their clinical handling is essential to maximize the potential of this technique.