Abstract
Diastemas among maxillary incisors and gingival contour disharmony are common findings among patients in dental practice. Ceramic veneers are indicated for esthetic rehabilitation of anterior diastemas due their predictable results, optical characteristics, fracture resistance and tooth structure conservation. However, because it is a friable material and have a brittle behavior, fractures occurrences are related to trauma, oclusal overload, parafunctional habits and material fatigue. This article describes 30 months follow-up of an esthetic and functional rehabilitation diastemas closure using feldspathic veneers associated with periodontal surgery and a ceramic repair with composite resin. Gingivectomy and frenectomy needs were found and the surgical procedures performed guided by new anatomic aspects of the crowns. Mock-up was performed after waxing and reverse planning. All anterior teeth underwent minimally invasive preparation. Feldspathic ceramic veneers were made, tried using try in paste and luted with light-cure resin cement. After 24 months, a fracture occurred on the right maxillary canine veneer. The ceramic restoration repair was performed with nano-hybrid composite resin, after the conditioning with 5% hydrofluoric acid, 37% phosphoric acid and silane couple agent. The combination between ceramic veneers and gingivectomy enables to obtain conservative treatments and esthetic success. After six months of the repair, resulting 30 months of follow-up, the anterior restorations were aesthetically and functionally satisfactory.
Highlights
Diastemas are classified as the presence of inappropriate space distribution in anterior region or tooth size discrepancy, which promotes aesthetic impairment (WOLFF et al, 2010)
The ceramic restorations present high color and surface smoothness stability when compared to composite resin (GAROUSHI et al, 2013)
Owing the need to improve diastemas and periodontal-compromised esthetics, and within successful evidences of feldspathic ceramics (MORIMOTO et al, 2016), as well as the role played by gingival architecture in the composition of the smile, this article approach a clinical case report describing gingivectomy and a 30 months follow-up of diastemas closure using feldspathic veneers and a ceramic repair with composite resin
Summary
Diastemas are classified as the presence of inappropriate space distribution in anterior region or tooth size discrepancy, which promotes aesthetic impairment (WOLFF et al, 2010). Owing the need to improve diastemas and periodontal-compromised esthetics, and within successful evidences of feldspathic ceramics (MORIMOTO et al, 2016), as well as the role played by gingival architecture in the composition of the smile, this article approach a clinical case report describing gingivectomy and a 30 months follow-up of diastemas closure using feldspathic veneers and a ceramic repair with composite resin. No clinical complications were observed until the 24-mounth follow-up After this period, the patient reported have forgetting to sleep with the oclusal splint and a fracture on ceramic veneer of right maxillary canine occurred (Figure 6-A). The anterior maxillary teeth were isolated with rubber dam and 5% hydrofluoric acid (PowerCething 5%; BM4, Palhoça, Santa Catarina, Brazil) were applied on the ceramic close to the fracture line for 60s. After six months of the repair, resulting in 30 months of follow-up, the esthetic restoration was aesthetically and functionally satisfactory (Figure 7A and B)
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