Playing defense with teeth

By: Sable A Muntean, DMD, MHSA

On a recent Friday afternoon, this 18-year-old female presented as a new patient to my office. She had fallen off her scooter the day prior, fracturing both #8 and 9, as seen in Figure 1 below.


My chief concern was the blushing of the pulp, as seen in Figure 2 below, but I immediately contacted the endodontist I refer to, to confirm what our best game plan would be for her.

I cannot stress enough, especially as a new dentist, how important it is to build a relationship with the specialists you refer to and have them on speed dial. I ask my contacts questions that help me create a better outcome for my patients and all parties involved succeed.


In my patient’s case, the most ideal treatment was to use Mineral Trioxide Aggregate (MTA), a hydrophilic, endodontic cement capable of stimulating healing and osteogenesis. After addressing that issue, I now needed to restore these teeth as perfectly as possible on this beautiful, young girl whose mother was watching my every move—no pressure!

Lucky for me, my trusty toolbox includes OMNICHROMA Flow by Tokuyama. Here is the thing though—you must know its limitation and how to get past it.

The main issue when it comes to this material for a Class IV is how to properly reconstruct a highly opaque tooth and block out the “darkness” of the rest of the mouth as the material has the tendency to be on the more translucent side.

How I got past this was by creating a lingual wall using Estelite Omega (also a Tokuyama product). This was now able to properly block out my concern, and then I reinforced it with the OMNICHROMA blocker over the facial portion. This works hand in hand with the flowable which I used as my final layer to create the final product, seen in Figure 3.


The first thing the patient and her mother said was, “WOW! You matched the color perfectly!” Thank you for the rebound, universal composite! 


Sable A Muntean, DMD, MHSA
Co-Director of ignitePreDent

Up Next: The Importance of Good Dental Records

Photo by Daniel Frank from Pexels

Sable Muntean

Sable Muntean

Doctor of Dental Medicine with Masters in Health Services Administration currently in an Advanced Education in General Dentistry residency. Experienced Marketing Director with a demonstrated history of working in the dental practice industry. Skilled in Nonprofit Organizations, Marketing Management, Business Planning, Coaching, and Sales. Co-Founder of ignitePreDent-- helping predental students with resources and mentorship to be admitted to dental school.