One for two

Based on the results of the scientific literature and the clinic, direct composite veneers offer a valid option for aesthetic rehabilitation. The minimally invasive approach, the good color matching as well as the functional and aesthetic biomimetics can offer great comfort and highly satisfy the patient’s expectation.
The patient, 47 years old, came to the clinic complaining about her smile. She presents incongruous old restorations of the upper incisors, thus two direct composite veneers on 1.1 and 2.1 were decided to be performed.

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Fig.1
Pre-operative buccal view of 1.1 and 2.1, showing several fractures and unaesthetic appearance of the old composites.

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Fig.2
A temporary restoration was fastly performed to prepare a silicon mold guide. The composite was placed without etching the surface, in order to easily allow its removal.

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Fig.3
The rubber dam application is mandatory to create an aseptic and dry environment. Two wooden wedges were placed to hold it.

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Fig.4
View of the silicon mold adaptation, placed to restore palatal walls.

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Fig.5
Sandblasting the surface can offer the best solution to achieve good adhesion of the restoration.

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Fig.6
Etching step: selective enamel etching using 3M ESPE™ Scotchbond™ Universal Etchant for 20 seconds.

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Fig.7
The teeth show the typical aspect of the etched pattern.

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Fig.8
Two layers of 3MTM ScotchbondTM Universal Adhesive was applied. Wetting well all the surfaces and then drying gently, ensure the best interdigitation into the etched enamel.

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Fig.9
Application of Filtek Universal Restorative (3M, ESPE) composite into the mold guide.

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Fig.10
Noteworthy is the perfect color matching with chameleon-like properties of Filtek Universal Restorative (3M, ESPE), that creates successful restorations with the need of less shades.

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Fig.11
Light-cured restorations after silicon guide removal.

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Fig.12
Using the same shade of Filtek Universal Restorativecomposite, tooth 1.1 was accordingly restored.

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Fig.13
Post-operative view of final restorations before finishing and polishing procedures.

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Fig.14
Contouring, finishing and polishing are the most critical steps to obtain the best and successfull restorations. Sof-LexTM Diamond Polishing System (3M, ESPE) can offer to clinicians the best solution for a simply and also satisfactory finishing and polishing technique. The beige Spiral Wheel was used for the finishing step.

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Fig.15
The pink Spiral Wheel was used for a good and appreciable smooth and glossy surface.

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Fig.16
Post-operative final result right after rubber dam removal and finishing and polishing procedures.

Conclusions

Single session restoration is convenient and economic compared to ceramic approach and may change the smile instantly. The composite gives always the possibility to modify, repair or reshape directly in the mouth easily. The single layer approach, the good tooth-restoration matching, and the unique creamy handling of 3M™ Filtek™ Universal Restorative  , offer a perfectly integrated aesthetic restoration.

Bibliography

1. Cerda-Rizo ER, de Paula Rodrigues M, Vilela A, Braga S, Oliveira L, Garcia-Silva TC, et al. Bonding Interaction and Shrinkage Stress of Low-Viscosity Bulk Fill Resin Composites With High-Viscosity Bulk Fill or Conventional Resin Composites. Oper Dent. 2019 Jan 31;
2. Van Ende A, De Munck J, Lise DP, Van Meerbeek B. Bulk-Fill Composites: A Review of the Current Literature. J Adhes Dent. 2017;19(2):95–109.
3.Benetti AR, Havndrup-Pedersen C, Honoré D, Pedersen MK, Pallesen U. Bulk-fill resin composites: polymerization contraction, depth of cure, and gap formation. Oper Dent. 2015 Apr;40(2):190–200.

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