Minimally invasive approach in esthetic dentistry: composite resin versus ceramics veneers

Giselle Rodrigues Reis,Ana Laura Rezende Vilela,Fernanda Pereira Silva,Paulo César de Freitas Santos-Filho,Marcela Gonçalves Borges,Murilo de Sousa Menezes

doi:10.14393/bj-v33n1a2017-34617

Abstract

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics. The conservative dental esthetic reestablishment treatments has been improved and evaluated with the development of adhesive materials. The adhesive dentistry allowed minimally invasive preparation through direct treatments with composite resin and indirect ceramic laminates veneers. These two treatments methods present advantages and disadvantages. The aim of this manuscript is to describe two clinical reports and compare alternatives to rehabilitate the smile esthetic appearance by direct and indirect minimally invasive treatments. In the first case, a 24-years-old patient, female, complained of unsatisfactory anterior maxillary size and incisal wear. After the functional and esthetic planning, nanoparticle composite resin by free hand technique was indicated to rehabilitation. In the second case, a 24-years-old patient, male, reported dissatisfied with his anterior central incisive shape. On clinical examination, maxillary anterior conoid teeth were verified. Based on this evaluation, a conservative treatment using minimally invasive ceramic veneers in maxillary central and lateral incisor and ceramic fragments on canine was planed to the smile rehabilitation. It can be concluded that conservative treatment using direct composite resin restorations and minimum thickness ceramic veneers laminate, even with their specific limitations and advantages, provide satisfactory esthetic and functional treatment results, preserving the dental structure.

Highlights

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics
Esthetic procedures on sound teeth are usually possible by composite resin and ceramic restorations
The survival rate of anterior resin restorations is predicted to be of 84.6% after 5 years of clinical service (FRESE et al, 2013), with annual failure rates which varies from 0 to 4.1% (DEMARCO et al, 2015)

Summary

INTRODUCTION

Unsatisfactory anatomical shape of anterior tooth promotes disharmony in the smile esthetics. It is possible to use a ceramic thickness of 0.3mm to 0.7mm, without mechanic properties disadvantages (GRESNIGT; KALK; OZCAN, 2012) The aim of this manuscript is to describe and compare two anterior rehabilitation alternatives, by direct nanofilled composite resin restorations and ceramic laminates veneers. A 24-year-old patient, female, attended to the Dental School of Federal University of Uberlandia, unsatisfied with her smile She presented the maxillary anterior teeth with unsatisfactory anatomy shape and incisal wear (Figure 1A and 1B). An approximately 0.3 mm minimally invasive prepare was done on maxillary central and lateral incisor using a diamond bur (#2214 F, KG Sorensen, Brazil) (Figure 7A and 7B) These prepares were performed to ensure the direction of the ceramic laminate veneers insertion and to round off sharp angles promoting higher resistance of restorative materials. Occlusal contacts were checked and the esthetic and cosmetic adjustments were done after cementation with extra-fine diamond burs (KG Sorensen, Cotia SP, Brazil) (Figure 8A, 8B and 9B)

DISCUSSION

CONCLUSION