Modern restorative dentistry is based on the principles of adhesion and minimal invasiveness. In 2011 prefabricated composite resin veneers with high conversion degree were launched in the market simultaneously obtaining two main advantages, they’re user-friendly and they have a good color, shape, and long-term stability. The perfect knowledge of the strengths and techniques of application of these materials is essential for every dentist to get the best results with a correct working time.
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28 years old female patient came to my office to improve her smile, asking for the less expensive and demanding treatment.
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Both the upper central incisors showed a IV Class fracture and an enamel wearing with an hypersensitivity.
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After a fast and very simple clinical evaluation, I decided to use preformed veneers to close the diastema and to solve fractures, enamel wearing and hypersensitivity at the same time, for their simple and predictable use. In order to show her my project before starting, I “glued” a couple of Componeers directly from their box, after a size evaluation, using orthodontic wax.
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To achieve patient’s agreement.
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Using an occlusal mirror to have a panoramic point of view.
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I realized that, despite to their low thickness, I would have had an incorrect alignment without a small vestibular preparation.
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So I started to slight and gently prepare them.
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Using Indirect Style kit burs.
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At the same time I modified shells shape using diamond abrasive discs.
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And burs in their cervical side.
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Until they fit well.
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Then, in order to fix their spatial position, I put a very little drop of composite in their middle internal side, without any adhesive system.
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Facial bow was taken while the patient is standing up,
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In fact, the smile must be set compared to the horizon, not to the pupillary line.
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When I was sure about their setting, I cured them for a few seconds.
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Before an easy removal with a spatula.
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I put the dam isolation on with a 212 Ivory clamp for anteriors and a cut auto matrix stabilized with wooden wedges.
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I etched the enamel with orthophosphoric acid for 30 seconds.
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And I rinsed for the same time to remove it completely.
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Before applying an etch and rinse two steps adhesive system.
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With a disposable brush until I reached a shiny surface.
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Bonding protocol is the same as indirect posterior composite restorations, with all the steps of adhesive and 50° C heated composite on the internal side of the veneer. It is compulsory to push the shells with a light and continue pressure ( in order not to have internal air bubbles ), until they fit well, before removing all the composite excess with Styleitaliano Fissura instrument.
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Due the fact I achieved a tooth elongation.
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I performed an inverse layering using a dentin composite mass from the palatal side to the vestibular one modeling mamelons.
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And spreading a little blue stain through them to give a soul to the shells. A simple way to mimic nature.
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Eventually a very thin enamel layer with a brush to finish the restorations.
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60 seconds curing time.
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And another session under glycerine gel to eliminate the oxigen from the surface
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Look at patient’s smile at the end of the treatment.
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And the palatal point of view.
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A very satisfying and natural outcome.
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1 year check-up shows a very good integration.
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Conclusions
This product makes it possible to perform the veneering in only one session offering a new cheap and predictable approach in the direct anterior restorations with a minimally invasive approach.
