Single shade in anterior veneers

Using a single shade for direct veneers is a great way to simplify this challenging procedure. Choosing between a direct and an indirect approach in anterior veneering should be based on a dentist’s self-assessment of his skills and preferences. But it is important, although, to always consider the most minimally invasive procedure. If we want to use a direct approach we need to have thorough knowledge of anatomy and color. Today we have a new material on the market (Brilliant Ever glow, Coltene) which will help  every dentist to create a very nice restoration using only one shade.
In this article we will discuss this quick and in a predictable way how to have a nice direct veneer with an easily polishable composite material.

style italiano styleitaliano dentistry

Fig.1
Before restoration

style italiano styleitaliano dentistry

Fig.2
We started to check color with VITA shade guide. The color of the teeth was whiter than B1 in the classical Vita Shade Guide

style italiano styleitaliano dentistry

Fig.3
To make sure that we choose the right color we always can use the button try technique. We put 1.5 mm thickness of composite on the tooth and check the color with a Polarizing filter (Smile Lite).

style italiano styleitaliano dentistry

Fig.4
It’s mandatory to isolate with the rubber dam for all adhesive procedures.

style italiano styleitaliano dentistry

Fig.5
With coarse discs we created a very small bevel and rounded all sharp edges

style italiano styleitaliano dentistry

Fig.6
In this case we didn’t need to prepare the tooth. We just wanted to clear the surface of the enamel and remove aprismatic enamel for better adhesion

style italiano styleitaliano dentistry

Fig.7
After sandblasting with aluminum oxide27 micron particles. (Aquacut or Rondoflex)

style italiano styleitaliano dentistry

Fig.8
First, we have to isolate adjacent teeth with teflon tape to carry out etching of the enamel for 30 seconds.

style italiano styleitaliano dentistry

Fig.9
The self etching One Coat Universal Adhesive (Coltene) was applied over the enamel. The adhesive excess was removed using aspiration and a blow of air. When the adhesive is not moving anymore under the pressure of the air, then we know that the thickness is close to optimal. Light curing will be minimum 10-20 seconds, depending on the power of your lamp.

style italiano styleitaliano dentistry

Fig.10
We started by applying the first layer of the new sub-micronic hybrid composite (Brilliant Everglow)

style italiano styleitaliano dentistry

Fig.11
The whole tooth was restored with one BL shade and for smoothening of the surface we use always CompoBrush (Smile Line)

style italiano styleitaliano dentistry

Fig.12
The final stage of our layering must always be air isolated with glycerine. Light curing for 1 minute.

style italiano styleitaliano dentistry

Fig.13
We need 3 main steps to obtain a good surface gloss: contouring, finishing and polishing. With coarse discs we start the contouring phase of our restoration.

style italiano styleitaliano dentistry

Fig.14
For the finishing of the cervical third we used rubber abrasive cups.

style italiano styleitaliano dentistry

Fig.15
For the finishing of the embrasures we used rubber abrasive points.

style italiano styleitaliano dentistry

Fig.16
To create the illusion of perykimata we always use diamond Perio bur from StyleItaliano Finishing Kit (Komet) at a very low speed without water irrigation.

style italiano styleitaliano dentistry

Fig.17
Polishing is finished with a silicone abrasive wheel (Diatech Polishers by Coltene).

style italiano styleitaliano dentistry

Fig.18
The final view of the polished composite veneers

style italiano styleitaliano dentistry

Fig.19
Before and after

Conclusions

It’s very easy to restore this kind of cases with a new medium translucency composite. We need just one shade to create very nice direct veneers.

Bibliography

References
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;5(1):102-24.
Manauta, J., Paolone, G. Devoto, W. IN ‘n’ OUT – A New Concept in Composite Stratification. Labline Magazine, 2013;3(2):110-127.
Manauta J. Controlled Body thickness Part 1 – www.styleitaliano.org
Manauta J, Salat A. Layers, An atlas of composite resin stratification. Quintessence Books, 2012. Print.
Akhundov M. Composite meets ceramics. http://styleitaliano.hime.host/composite-meets-ceramics

RELATED CASES

Single-visit diastema closure

How to restore a central incisors large diastema in one single visit with an easy and repeatable direct composite restoration