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WALTER DEVOTO
DIRECT ANTERIORS - CASES - SHADEGUIDES

EASY ISOLATION FOR DIFFICULT CASES

EXTERNAL TOOTH
WHITENING
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Aesthetic dentistry in paediatrics is possible, how to overcome the difficulties to isolate and stratify in
children.
Precise composite layering is the key of any good aesthetic restoration in anteior teeth: for this
purpose, we suggest making a silicone stent to establish the restoration shape and help the clinician
during composite stratification,
The silicone stents have many other applications, for example, in pediatric cases, where the patient
often does not tolerate the rubber dam or some of their semi-erupted teeth do not allow an optimal
isolation.

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The tips below allow the easy restoration of anterior teeth after a traumatic event.
An article by Walter Devoto submitted on 13/02/2012

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The patient comes to the office with fractures on the 11 and 21 after an accident at school: As an
emergency treatment, the teeth are disinfected with 2% clorhexidine for 1 minute and protected
with a layer of bonding.

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After the emergency treatment, two impressions are taken and a wax-up of the fractured area is
done in the laboratory.

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FOUNDERS
It is well known that in paediatric cases it is very difficult to isolate the field with the classical rubber

dam, either because the fractures are deep, or because the adjacent teeth are semi-erupted or
simply because the small patient does not tolerate the dental procedures well.

Walter Devoto
Dr. Walter Devoto Born in
Chiavari on 29/03/1965
graduated in Dentistry in 1991
at Genova University.

Angelo Putignano
M.D. degree and D.D.S. post
graduate certificate from
University of Ancona-Italy.

FOUNDERS ENDO

In this case we use the silicone stent as a guide, while at the same time it is a simple solution to
substitute the rubber dam. It also allows the young patient to close their mouth during the bonding
and layering stages.

Pio Bertani
Pio Bertani is a full member of
the prestigious association...

Fabio Gorni
Fabio Gorni is an active
member of the Italian Society
of Endodontics and the Italian
Academy...

MEMBERS
Monaldo Saracinelli
Ive been a student of prof.
Fabio Toffenetti and
Riccardo Garberoglio.

Jordi Manauta
Was born in Mexico City,
where he graduated cum
laude. in dentistry from
UNITEC.

Gaetano Paolone
My passion is aesthetic
direct and indirect
adhesive dentistry in
anterior and posterior
teeth.

Daniele Rondoni
Born in Savona in 1961
where he lives and has

The silicone stent is placed in the mouth at the next appointment.

Indications
- Presence of diastema
- Impossibility to use the rubber dam
- Coronal sealing of the silicone

worked in his own

laboratory since...

Vincenzo Musella
Vincenzo Musella
graduated in dental
technician. Proud friend
and student of...

Giuseppe Marchetti
Giuseppe Marchetti was
born in Parma (Italy) in
October of 1972 and
graduated from...

Simone Grandini
Chair of Endodontics and
Restorative Dentistry,
University of Siena, Italy.

Giovanna Orsini
Giovanna Orsini is a well
known researcher in Italy
and internationally.

Paulo Monteiro
My passion for esthetic
dentistry began when I
attended the last year...

Louis Hardan
Head of Restorative and
Esthetic department in
Saint-Joseph University
in...

The silicone allows the patient to close their mouth in a comfortable position, as we can appreciate
in this lateral view.

Patrizia Lucchi
Patrizia Lucchi Graduated
in Dentistry cum Laude in
1995 at the University of
Verona

Anna Salat
Dr Anna Salat graduated
with a degree in dentistry
from the International
University of Catalonia

Giulio Pavolucci
After graduation magna
cum laude in Dentistry, I
started focusing my daily
work on...

Marcos Vargas
Dr. Marcos Vargas
attended Cayetano
Heredia University School
of Dentistry in Lima...

Stefan Koubi
Dr. Koubi graduated from
University of Marseille
where he...

Engin Taviloglu
Dr. Taviloglu graduated
from ?stanbul University
School of Dentistry in...

The patient with the silicone stent. The fact of being able to close their mouth offers a relaxing
sensation and comfort while allowing us to work precisely.

Dimitar Filtchev
Co-founder of the Laser
Dental Center and the
Implant...

Angie Segatto
My commitment to arts has
determined my
specialisation.

Kilian Molina
Kilian is required as a
regular lecturer in indirect
restorative...

Gregory Camaleonte
I was born in 1980 in
Marseille-France and i have
graduated in 2006 from...

Caroline Werkhoven
Caroline Werkhoven
graduated in 2002 at
ACTA, the dental faculty in
Amsterdam..

Ajay Juneja
Ajay Juneja finished his
BDS in the year 1995...

The silicone guide must fit perfectly, sometimes small adjustments can be carried out with an
scalpel blade to help the stent fit better. We canwork through the specially designed windows.

Carlos Fernndez
Villares
Member of SEPES Spanish
Soc...

Sulivan Leite
Sulivan Leite graduated
from the Ribeirao...

Maciej Zarow
Author of book edited by
Quintessence: EndoProsthodontics: guidelines
for clinical practice ...

Dan Lazar
Dan Lazar, graduated from
the Faculty of Dentistry in
2005 in Cluj-Napoca...

Murad Akhundov
Dr. Murad Akhundov
graduated from the
Faculty of Dentistry in
Baku...

Janos Grosz
Graduated summa cum
laude in 2006 from the
University of Szeged,
Faculty of Dentistry,
Hungary...

The patient does not needs to open their mouth during the procedures. We can etch and bond easily
and with no risk through the windows.

MEMBERS ENDO
Simone Grandini
Chair of Endodontics and
Restorative Dentistry,
University of Siena, Italy.

Louis Hardan
Head of Restorative and
Esthetic department in
Saint-Joseph University
in...

Filippo Cardinali
Graduate in Dentistry and
Dental Prostheses at the
University of Ancona in
1992. Active Member of...

Riccardo Tonini
He is active member of the
Italian Academy of
microscopic Dentistry and
Active member of...

Paolo Generali
Doctor Generali was
graduated from Pavia
University in the year...

The palatal enamel placed and adapted precisely without moving the stent or the patient.

Calogero Bugea
Graduate in Dentistry,
Certificate in Oral Surgery.
Active Member of the
International
Piezosurgery...

Clifford Ruddle
Internationally recognized
as a leading expert in all
aspects of clinical
endodontics, Dr. Ruddle is
acclaimed for...

Pierre Machtou
Pierre Machtou was the
first scientific director and
general secretary of the
French Endodontic
society...

Marga Ree
Primary author of several
articles published in
national and international
journals and has ...

Marco Martignoni
Marco Martignoni leads a
private clinic in Rome Italy
and dedicates his practice
mainly to endodontics,
pre-prosthetic...

Massimo Giovarruscio
Massimo Giovarruscio
works in Rome, Bristol and
London, specialising in
Endodontic Treatment
and...

Opaqe dentins are placed and some white spots are carried out to immitate the nautral teeth.

The case finished and polished shows a perfect integration with the other teeth thanks to the
precision of the layering stage.

The case before.

The case after.

Colour and shape integration must also take place as well on the palatal walls to avoid occlusion issues
and future filtration.

A control one week later assures us that the colour is correct after teeth are re-hydratated.

A follow up some months later with the childs smile!!

Conclusions
This technique is extremely useful in patents who
- Do not tolerate the rubber dam
- Mixed dentition
- Suffer from mouth opening
- Presence of diastemas
References
- Devoto W, Saracinelli M, Manauta J. Composite in everyday practice: how to choose the right
material and simplify application techniques in the anterior teeth. Eur J Esthet Dent. 2010
Spring;5(1):102-24.
- Salat A, Devoto W, Manauta J. Achieving a precise color chart with common computer software for
excellence in anterior composite restorations. Eur J Esthet Dent. 2011 Autumn;6(3):280-96
- Paolone G, Orsini G, Manauta J, Devoto W, Putignano A. Composite shade guides and color
matching. Int J Esthet Dent. 2014 Summer;9(2):164-82
- Vanini L. Light and color in anterior composite restoration P.P.A.D. 1996; vol 8, n 7; 673-682

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