A conservative aesthetic rehabilitation on pigmented anterior teeth: Three years follow-up

João Victor Frazão Câmara,Luis Alexandre Maffei Sartini Paullilo

doi:10.5348/101153z01ea2020cr

Abstract

Introduction: Aesthetic dentistry values the alignment of teeth and harmonization of the smile, and several techniques can be applied to close diastemas. Here, we presented an aesthetic approach to restore the smile balance with porcelain veneers. Case Report: A 46-year-old female patient sought dental treatment complaining of dental clenching and smile appearance. Pigmented anterior teeth and fractured indirect restoration were observed. Tooth bleaching was performed with 35% hydrogen peroxide and the impression of the jaw was obtained to perform the diagnostic waxing and a surgical guide in silicone. The guide was inserted and the gingival margin recorded with a scalpel. A mucoperiosteal flap was performed and the gingival collar extracted. For osteotomy, the distance between the edge guide and the cervical bone was measured with surgical chisels and carbide/diamond drills. From the dental mold, silicone impressions for use in the mock-up and in the making of the temporary restoration were made. The cementation protocol for the facets was carried out with hydrofluoric acid for 30 seconds. Conclusion: The present protocol proved to be effective when correctly indicated and executed, rehabilitating the patient’s aesthetics and function.

Highlights

Aesthetic dentistry values the alignment of teeth and harmonization of the smile, and several techniques can be applied to close diastemas
To improve tooth color, porcelain laminate veneers are used for esthetic treatments involving morphological modifications related to shape, size, and volume [1]
A composite resin treatment may be indicated for a less invasive approach, due to its susceptibility to discoloration, wear, marginal fractures, which would reduce the esthetic result in long term

Summary

INTRODUCTION

The demand of esthetic procedures is increasing. On that cases, metal free restorations, such as porcelain laminate veneers and crowns, are good alternatives of treatment. Silicone (Zetaplus, Zhermack, Labordental, São Paulo, Brazil) (Figure 1D–H) impressions were obtained to use for the mock-up (Figure 3) and the confection of the temporary restorations (Figure 2C–E). This procedure allows a tridimensional previsualization of the final result and a guidance for teeth preparation, allowing a conservative wear [7]. The luting agent used in this case was a lighting-cure resin cement (Variolink Multilink) It was applied in the internal surface of the veneer, and positioned on the teeth (Figure 5H and I). The final result (Figure 4A and B) and follow-up after three years can be seen on the facial (Figure 4C) and intraoral (Figure 4D and E) photographs of the patient

Findings

DISCUSSION

CONCLUSION