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.
Fig.1
Before restoration
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
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).
Fig.4
It’s mandatory to isolate with the rubber dam for all adhesive procedures.
Fig.5
With coarse discs we created a very small bevel and rounded all sharp edges
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
Fig.7
After sandblasting with aluminum oxide27 micron particles. (Aquacut or Rondoflex)
Fig.8
First, we have to isolate adjacent teeth with teflon tape to carry out etching of the enamel for 30 seconds.
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.
Fig.10
We started by applying the first layer of the new sub-micronic hybrid composite (Brilliant Everglow)
Fig.11
The whole tooth was restored with one BL shade and for smoothening of the surface we use always CompoBrush (Smile Line)
Fig.12
The final stage of our layering must always be air isolated with glycerine. Light curing for 1 minute.
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.
Fig.14
For the finishing of the cervical third we used rubber abrasive cups.
Fig.15
For the finishing of the embrasures we used rubber abrasive points.
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.
Fig.17
Polishing is finished with a silicone abrasive wheel (Diatech Polishers by Coltene).
Fig.18
The final view of the polished composite veneers
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
