Indirect composite veneers for post-endodontic rehabilitation

A clinical case by our Community member Dr. Hung Bui

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.

Nowadays, composite is one of the materials able to provide very highly esthetic results. Along with its high flexural strength, composite is widely applied to a wide variety of cases, including direct and indirect restorations.
In this case, I decided to choose composite as the material to be used, because of its aesthetics, durability, and affordable cost.

decayed teeth style italiano styleitaliano community

Fig.1
Initial situation: discoloration of tooth 12, old direct restorations at teeth 11, 21, 22. The patient wanted improve the appearance of her smile, while not having sufficient financial resources for ceramic restorations, so composite was chosen as a material for this case.

teeth after cleaning caries style italiano styleitaliano community

Fig.2
After removing old restorations, teeth 12, 21, 22 were treated endodontically and restored with post and core.

X-rays showing root canal treatments style italiano styleitaliano community

Fig.3
X-rays after endodontics and post and core treatment.

esthetic wax-up style italiano styleitaliano community

Fig.4
Wax-up on stone model. Although restarting the canines would have been advisable for aesthetic purposes, they weren’t included in the treatment because of financial reasons.

side view of wax up on plaster model styleitaliano style italiano community

Fig.5
Wax-up, lateral view.

provisional resin restorations style italiano styleitaliano community

Fig.6
Provisional restorations were made using Luxatemp A1 (DMG).

composite veneers and crowns style italiano styleitaliano community

Fig.7
Indirect restorations are made by Harmonize composite, A2 shade (Kerr Dental).

preparations for composite restorations styleitaliano style italiano community

Fig.8
The prepared teeth were isolated by placing the rubber dam.

sandblasted prepared tooth abutments style italiano styleitaliano community

Fig.9
Sandblasting by AquaCare to clean and get higher bond strength.

cemented composite veneer restorations style italiano styleitaliano community

Fig.10
Cementation by Variolink Esthetic Neutral resin cement (Ivoclar Vivadent). Excess cement was removed and finish lines were cleaned and polished.

composite indirect restorations right after cementation style italiano styleitaliano community

Fig.11
Immediate result after cementation.

xrays after composite cementation style italiano styleitaliano community

Fig.12
X-rays were taken after cementation to check continuity and close fitting of the indirect composite restorations.

before and after composite indirect rehabilitation style italiano styleitaliano community

Fig.13
Before and after.

side view of composite restorations styleitaliano style italiano community

Fig.14
At 3-month follow-up.

smile showing composite restorations style italiano styleitaliano community

Fig.15
The new smile after 3 months.

Conclusions

Indirect composite restorations are an easy and quick solution for highly esthetic results. For simple cases, indirect composite restorations is more economical than ceramic, and easier to perform than direct restoration.This method is suitable for practitioners who are young or need more training for full direct and indirect, ceramic-based treatments.

Bibliography

1. Gargari M, Ceruso FM, Pujia A, Prete V. Restoration of anterior teeth using an indirect composite technique. Case report. 2013 Apr; 6(4): 99–102.
2. Rappelli G, Coccia E, Putignano A. Restoration of anterior teeth with indirect composite partial coverage crowns: A clinical report. December 2004. The Journal of Prosthetic Dentistry Volume 92, Issue 6.
3. Monteiro P. Direct and indirect composites: the step by step video. 2017. www.styleitaliano.org.

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