Direct composite veneering for a new smile

A clinical case by our Community member Dr. Stefano Gelli

This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.

Direct composite veneers have gained an important role in dental clinical applications. It can be a perfect minimally invasive and long-lasting treatment to enhance shape and incisal embrasures of the teeth. As the dental biomaterials and methods grow, the clinicians also had the chance to imitate dental tissues and to create a very natural restoration. The crucial criteria to achieve these cases are to learn dental morphology and to master the different layers of composite.
This article describes the necessities of direct composite veneers for the success of a smile makeover. In addition, this case elucidates how to perform a minimally invasive, long-lasting, functional and natural smile with direct composite veneers on maxillary incisors in a single visit.

styleitaliano style italiano smile with narrow teeth and multiple diastemata

Fig.1
A young male patient, 25 years old, sought care at our dental clinic in order to improve the esthetics of his smile with direct composite veneering.

styleitaliano style italiano intraoral picture before direct veneering of teeth

Fig.2
A retracted view of the upper arch is crucial. After clinical and radiological evaluation, we proceeded with the esthetic planning to optimize tooth morphology. Enhancing the smile of our patient needed a good smile design, and a good composite material as direct composite veneers were indicated. Once the patient accepted our treatment plan after a direct mock-up, we performed the restorations. To improve the chromatic aspect, we performed an at-home bleaching of both dental arches. We waited for two weeks before executing the final composite restorations of the upper arch.

styleitaliano style italiano silicone index during application of the palatal composite layer

Fig.3
Rubber dam was placed for isolating the teeth. Floss ligatures retracted the papillae and allowed optimal control over the emergence profile of the future restorations.
After good isolation, a silicone index was fabricated based on the wax-up, to place the palatal composite shells. Si E (White Dental Beauty) was used to give translucency and good opalescence assets to the restorations.

style italiano styleitaliano white dental beauty composite system
style italiano styleitaliano white dental beauty composite system
styleitaliano style italiano layering of direct veneers with composite

Fig.4
Next, the SIO shade (White Dental Beauty) was placed over the enamel palatal wall before placing the final layer and building the mamelons.

styleitaliano style italiano translucent composite layer for direct veneering

Fig.5
A translucent composite was used in between the mamelons to enhance the halo effect.

styleitaliano style italiano direct veneers on upper incisors

Fig.6
The enamel E shade (White Dental Beauty) was used as a final composite layer in order to give the restoration a more natural appearance. Note: LM Arte Solo Anterior instrument (LM, powered by Styleitaliano) was used for layering the entire labial surface.

style italiano styleitaliano lm arte solo instruments
style italiano styleitaliano lm arte solo instruments
styleitaliano style italiano polished direct composite veneers

Fig.7
Final result.

styleitaliano style italiano smile with direct composite veneers

Fig.8
The patient’s satisfied smile after 2 months.

Conclusions

The indications for direct composite veneers have recently been enlarged to include predictable application in the esthetic zone. The accessibility of composite materials with perfected physical and optical features simplifies the advance of enhanced esthetics while maintaining vital function.
Direct composite veneer restorations can be a treatment choice for patients with esthetic problems of anterior teeth and should be applied carefully with good patient hygiene motivation.

Bibliography

1.Birnbaum NS. Direct oven-tempered hybrid compositeresin laminate veneers. Pract Periodontics Aesthet Dent. 1992;4(5):23-31.
2. Ferracane JL, Mitchem JC, Condon JR, Todd R. Wear and marginal breakdown of composites with various degrees of cure. J Dent Res. 1997;76(8):1508-1516.
3. Fahl N Jr, Ritter AV. Composite Veneers: the DirectIndirect Technique. Chicago, IL: Quintessence Publishing Co; 2020.
4. Birnbaum NS. Heat-tempered composite resin laminate veneers. Curr Opin Cosmet Dent. 1994;52-5.
5. Fahl N Jr, Ritter AV. Composite veneers: The directindirect technique revisited.J Esthet Restor Dent. 2021.

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