A clinical case by our Community member Dr. Zlata Stepanova
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.
The aesthetics of the smile is a significant part of interest in dentistry, and restoring the anterior area is challenging due to the complex dental anatomy and the need for natural-looking results. This article provides a comprehensive review of our experience, concepts, techniques, and materials used in the esthetic proposal and finalization of partial anterior restorations. Our practical insights and guidelines for delivering predictable, natural-looking, and long-lasting anterior restorations are shared in this article.
Collaboration between the dentist and the patient is crucial in planning a smile. By working collaboratively with the patient, a personalized treatment plan can be created that addresses their specific concerns and achieves the desired esthetic outcome, resulting in a beautiful and confident smile.
Fig.1
Initial frontal view of the patient’s smile, documenting preoperative aesthetics and function
Fig.2
Mock-up of the proposed smile design confirmed by the patient for alignment with expectations.
In a case involving a 35-year-old woman who wished to improve her smile, we created a mock-up to show the patient and ourselves a concept of the future smile.
We believe that patient wishes should be followed closely at this stage, as one of the main tasks of modern dentistry aesthetics is to make the patient happy and self-confident.
Once the patient confirmed the mock-up, we started the preparation process by preserving the enamel on the tooth, which is crucial to the longevity of the restoration.
Fig.3
Enamel fully preserved during conservative preparation, optimizing adhesion and longevity.
Fig.4
Digital depth gauge used for precise enamel reduction during preparation.
To administer adequate prep depth, we employed digital control of preparation. We scanned the teeth before and after preparation, and the scanner correlated these two scans, allowing us to identify areas that needed more or less preparation.
Fig.5
The Veneer Me device by StyleItaliano streamlines veneer preparation for bonding.
We used StyleItaliano Veneer ME to prepare the veneers for fixation.This device allows to prepare veneers for fixation easily and quickly.
Fig.6
Veneer try-in confirming ideal fit, shade, and morphology prior to cementation.
Fig.7
Veneer try-in conducted with glycerin gel or specialized try-in paste ensures accurate assessment.
Before light-curing, we showed the ready porcelain veneers to the patient and made a try-in to confirm everything.
Fig.8
Retraction paste effectively controls bleeding post-removal of temporary veneers. Bleeding during the removal of temporaries is a common problem during fixation, which can be resolved by using retraction paste to create a comfortable and dry working surface.
Fig.9
Mono-cord during cementation improves visibility of the finishing line.
We used one mono cord during fixation for better visualization of the finishing line, removal of gingival liquids, and easy removal of excess cement after light-curing.
Fig.10
A simplified protocol preserves soft tissue integrity throughout the procedure.
Fig.11
Split-dam with retraction cord is essential for isolation when working without a rubber dam.
We also used Splitdam with retraction cord to isolate and ensure the patient’s comfort during the fixing of the anterior teeth.
Fig.12
Numbered compartments on the device prevent veneer misplacement during the procedure.
Fig.13
All ten veneers bonded simultaneously for time efficiency and uniformity.
We then fixed the veneers, and after the final light-curing, we used a bilateral crescent scalpel and metal strips with hand-made notches to remove excess cement from the proximal surfaces.
Fig.14
Mono-cord simplifies excess cement removal, preserving precision in margins.
Fig.15
Bilateral crescent scalpel facilitates quick and safe removal of excess cement.
Fig.16
Handmade saws and metal strips with custom notches efficiently clean proximal surfaces.
Fig.17
Hand made saws for proximal surfaces.
Fig.18
Glycerin applied before final light curing eliminates the oxygen-inhibition layer.
Fig.19
Frontal view of the veneers post-cementation demonstrates excellent aesthetic outcome.
The restorations were fabricated using Ezneer Zirconia (Aidite, Qinhuangdao, China) and received a special surface treatment to enhance the bond strength of the veneers.
Fig.20
Occlusal view of the veneers highlights functional accuracy and stability.
Fig.21
Immediate postoperative smile reveals enhanced aesthetics and patient satisfaction.
Conclusions
In conclusion, by following these techniques, materials, and technologies, we can deliver predictable, natural-looking, and long-lasting anterior restorations that meet the aesthetic goals of the patient while preserving the overall health of the teeth.
Bibliography
- Devoto, W. Good Practice in Minimal Preparation: How to Get Your Patient and Technician What They Need.
- Koubi, S. Laminate Veneers: 20 Recipes for Smile Design. 1st ed., QP France, 2019.
- Magne, P. Bonded Porcelain Restorations in the Anterior Dentition. [PDF Preview].
