Author(s): Erturk Bilgec
Composite veneers which are used to treat anomaly and discolorations on teeth, preferred widely. In this case report, the aesthetic problems solved in a session with direct composite laminate veneers on the maxillary lateral incisors which has anomaly and discolorations. 19 year old young female patient presenting discolorations on upper anterior teeth referred to our clinic. She reported that she had little time, and it will be harmful to apply prosthesis. As a result of intraoral and radiographic examination of the patient composite laminate veneer procedure was decided to be applied. A2 colored (Herculite XRV, Kerr, Scafati, Italy) composite, (Alpha Etch Jel, Rio de Janerio, RJ, Brazil) 37% orthophosphoric acid and (Optibond, Kerr, Scafati, Italy) bonding were used for composite laminate veneer application. In composite and adhesive systems’ improvements are to use them safely. Composite laminate veneer applications are used in wide application areas thanks to features that are easy, economic and minimally invasive.
Esthetic treatment of a single darkened tooth represents a great challenge to the dental practitioner. The properties of dental ceramic- color stability, mechanical strength, clinical longevity, esthetic appearance and compatibility with periodontal tissues make this material a good choice for such treatment. We present a case of restoration of a single, highly darkened anterior tooth with a Feld spathic porcelain veneer. Resolution involved preparation of the dental structure guided by orientation grooves and provisional restoration using composite resin, a silicone impression and adhesive luting. Conservative use of porcelain laminate veneers provides satisfactory esthetic outcomes and preserves sound tooth structure. The patient was very satisfied with the result and had no complaints during 2 years of follow-up.
The purpose of this case report was to restore severely discolored and fractured non-vital maxillary central incisors with direct resin composite laminate veneers and to discuss the short-term follow-up. A 17 years old male patient presented to Istanbul Ayd?n University Faculty of Dentistry because of aesthetic reasons. After radiographic and clinical examination, severe discoloration and fracture of maxillary central incisors were diagnosed. First of all, endodontic retreatment and internal bleaching were performed. Then the teeth were prepared for resin composite laminate veneer restorations. The teeth were etched with 37% phosphoric acid, restored with an adhesive system and a nano-hybrid composite. Finishing and polishing procedures were performed immediately. As a result of the six-month control, the patient was very satisfied with the image of his teeth that still preserve the natural tooth like appearance. Direct resin composite laminate veneer is a cost-effective treatment option to restore anterior teeth aesthetically. This treatment procedure is useful for the growing patients before any definite restoration planning. A patient in his early 20s with teeth badly discolored by tetracycline was seeking treatment to improve his esthetics. Because retreatment and cost were important considerations, porcelain veneers were the treatment of choice. The challenge in this case was to mask the underlying tetracycline stain before the final cementation and thus gain more control over the final shade of the veneers.
A young patient with badly discoloured teeth was seeking treatment to improve his esthetics. His perception of his appearance had an important influence on his self-confidence. Retreatment and biological cost were important considerations. The patient was in his early 20s. Teeth may be discoloured as a result of tetracycline intake during a prophylactic or therapeutic regimen in the pregnant female or in the infant. Tetracycline and similar antibiotics have a selective affinity for deposition in bone and tooth substance.
The portion of the tooth stained by tetracycline is determined by the stage of tooth development at the time of drug administration. The discoloration itself depends upon the dosage, the length of time over which administration occurred and the type of tetracycline. The teeth affected by tetracycline appear to have a yellowish or brownish-grey discoloration, which is most pronounced at the time of eruption of the teeth. This discoloration gradually becomes more brownish after exposure to light. Typical indications for veneers include teeth that are malformed, rotated or malposition. Veneers may also be used to close single or multiple diastemas to change the color of unattractive teeth, to restore abraded or eroded restorations or to cover and replace faulty restorations. Other factors such as stain etiology, occlusion and the age, health and oral hygiene of the patient are important considerations in the treatment plan.
Masking tetracycline stains is one of the ultimate tests for porcelain veneers. It is difficult to mask dark underlying tooth colour and retain a natural appearance of the veneers. A very important factor in successfully covering these stains is the area of each tooth that is affected. Staining of the incisal third or the middle third of the teeth is relatively easy to cover. Staining of the gingival third is a difficult situation for veneers. The challenge in this case was to mask the underlying tetracycline stain before the final cementation, which enabled more control over the final shade of the veneers.
Some operators prefer to etch the tooth and apply the veneer directly over the entire untouched facial surface, thereby not removing any enamel. Several problems exist with such a method. The reversibility of these veneers may seem desirable, but the esthetic results and physiological contours are not always optimal. In fact, restorations are usually over-contoured and gingival inflammation may be observed. The removal of some enamel before placing a veneer is recommended to achieve ideal esthetic and physiological results. A clear finish line and specific surface reductions will facilitate laboratory fabrication and cementation.
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