The Biological Active Intrasulcular Restoration (BAIR) Technique

Purpose: To change the emergence profile by direct restorations. The proposed method allows the management of the portion of tooth covered by soft tissues through the use of a circular metal matrix. Case Report: This technique is based on the use of a common circular metal matrix (Automatrix Band, Dentsply/Caulk) that allows isolation of the operative site, while simultaneously moving the soft tissues and providing clear access to the intrasulcular portion of the tooth. The matrix is positioned around the tooth, tilted, pushed in the cervical direction keeping it adjacent to the tooth, and slid down to fit into the gingival sulcus. Once in the sulcus, the metal matrix is gently pushed to move the soft tissues. The space created by the matrix allows the easy application of adhesive and composite, thus facilitating the rebuilding of a new, "artificial CEJ". The first composite layer is particularly important: it must be applied while the edge of the matrix is in close contact with the tooth, in order to obtain a change of the emergence angle without causing overhangs. The new emergence profile will guide the soft tissues to adapt into the desired position. Results: The subgingival portion of the restoration is perfectly smooth because it is polymerized in contact with the metal matrix in the absence of oxygen. Therefore, it does not require any finishing and polishing. It is possible to lengthen the clinical crown without any surgical intervention, very often even without the need for anesthesia. The BAIR technique proves useful in the closure of pronounced diastemas, the transformation of malformed, small, or peg-shaped teeth, and balancing the gingival contour. In the treated cases, the soft tissues did not show signs of having suffered, neither in the immediate post-operative exam nor in the follow-up. Indeed, the gingival situation improved. No patient thus treated has ever complained or reported any discomfort or bleeding. It is possible to change a smile in a single appointment, in a non-invasive way, at low economic and biological costs, even in young patients. Conclusion: The BAIR Technique, based on the use of metal matrices that simultaneously allow isolation of the operative site and displacement of the soft tissues in a non-traumatic way, makes it possible to rebuild a new intrasulcular "artificial CEJ" and change the natural emergence angle. The new emergence profile will impel the gingiva to adapt to the desired position. Using this rapid, non-invasive, and reversible therapy, it is possible to solve esthetic and functional problems, not only at the tooth level but also at the gingival one.