A clinical case by our Community member Dr Mohammed Haji
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.
One of the most crucial criteria in modern dentistry is the reestablishment of a patient’s dental aesthetics. Recent advancements in the field of adhesive dentistry have broadened and changed restorative dental practice. In fact, dental composite veneers have developed into a solution for anterior teeth in the modern dental industry with a tendency towards minimal intervention. Direct placement of composite veneers provide greater material control, you do not have problem with the undercanyuts, directly you can show the result to the patient, require only a small amount of tooth structure to be removed, and is easily repairable and modifiable at point.
Fig.1
A 26-year-old female patient visited the dental office and requested a solution for her short and worn teeth. She wanted a smile with better teeth proportions, and a her teeth to be a little whiter.
Fig.2
Side view of her teeth, maxillary anterior teeth do not touch the lower lip during smile.
Fig.3
Fully retracted lip, checking the zeniths.
Fig.4
Retracted lip with mouth retractor and contraster. This view really highlights the irregularity of the incisal edges.
Fig.5
A split dam isolation was used together with a retraction cord for full control over cervical adhesion and emergence profile.
Fig.6
During the adhesive procedure on the central incisors, the adjacent teeth were covered with teflon tape. Layering started with the build up of the tmamelons using a body shade.
Fig.7
The layering included the following shades:
– BW as body shade and incisal halo
– OBN and ECC for translucent zone
– WE as enamel shade for facial and proximal surfaces
Using LM Solo Anterior for shaping of composite and Compobrush with modelling liquid for adaptation of the composite.
Fig.8
Analyze the shape and symmetry from the right to left side of teeth, then start finishing step.
The proximal walls were created using transparent matrices, and finishing was carried out using Soflex discs and the Enhance bur for the prepolishing step. FLEXI-D polishing Discs (EVE) were used to create transitional line angles and polishing the proximal surface.
Fig.9
Using Essential Twinkle System (Jota) for texture and a goat brush, and felt (Diaswiss) for polishing.
Fig.10
Before and after, with rubber dam.
Fig.11
Using Lucida DiaShine polish for final gloss.
Fig.12
Photo with contraster to highlight the incisal edges ,transitional line angles, incisal embrasures and texture.
Fig.13
Smile line correction.
Fig.14
Full smile with healthy gingiva.
Fig.15
Highly polished surface.
Fig.16
Patient can smile with more confidence.
Fig.17
Another side view.
Fig.18
Final result.
Fig.19
Before and after, retracted view.
Fig.20
Before and after, smile.
Conclusions
Nature is the ideal model to imitate, and the comprehension of what nature looks or feels like is essential in aesthetic dentistry. Nowadays, clinicians are able to offer beautiful smiles conservatively without any loss of the tooth structure. It was a challenge to combine the functional, aesthetic, and biological considerations to satisfy the patient.
Bibliography
- Manauta J, Salat A. Layers, An atlas of composite resin stratification. Quintessence Publishing Co; 2012.
- Hardan L, Bourgi R, Kharouf N, Mancino D, Zarow M, Jakubowicz N, Haikel Y, Cuevas-Suárez CE. Bond strength of universal adhesives to dentin: A systematic review and meta-analysis. Polymers. 2021 Mar 7;13(5):814.
- 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 Mar 1;5(1):102-24.
- Devoto W, Pansecchi D. Composite restorations in the anterior region: clinical and aesthetic performances. Practical Procedures & Aesthetic Dentistry: PPAD. 2007 Sep 1;19(8):465-70.
- Ortensi L, Sigari G, La Rosa GR, Ferri A, Grande F, Pedullà E. Digital planning of composite customized veneers using Digital Smile Design: Evaluation of its accuracy and manufacturing. Clinical and Experimental Dental Research. 2022 Apr;8(2):537-43.
