Composite Resin Veneers Research Articles

The Thickness and Opacity of Aesthetic Materials Influence the Restoration of Discolored Teeth.

This study aimed to evaluate the influence of thickness and opacity on the ability of composite resin and ceramic veneer restorations to mask discolored teeth. Ninety veneers were made of lithium disilicate ceramic, shades BL1 and 0 (IPS e.max Press, Ivoclar Vivadent), and 60 were made of composite resin, shade BL-L (IPS Empress Direct, Ivoclar Vivadent). The veneers measured 4 mm in width x 4 mm in length and had a thickness of 0.7, 1.0, or 1.2 mm. One hundred and fifty human premolars were selected to obtain 150 dental fragments with the following dimensions: 4 mm x 4 mm x 3 mm (width x length x thickness). The fragments were discolored, submitted to color measurement and randomly assigned to 15 groups (n=10) according to the type and opacity of the restorative material (IPS e.max Press: high translucency [HT], low translucency [LT], and medium opacity [MO]; IPS Empress Direct: dentin and enamel) and thickness of the veneers (0.7, 1.0, and 1.2 mm). After cementation of the ceramic or composite resin veneers using a translucent resin cement (RelyX veneer, 3M), a final color measurement was taken from each specimen and the total color variation (ΔE) was calculated by subtracting the initial and the final color measurement. The final lightness (L*) of the restored dental fragments was also calculated. The highest ΔE values were observed for the LT and MO ceramic groups, followed by dentin composite resin. Regarding the different thicknesses of ceramic veneers, every 1.2-mm-thick group had higher values of ΔE, considering their respective opacities (p<0.05). The highest lightness values were found for the LT and MO ceramic veneers (thickness of 1.2 mm). Dentin-shade composite resins showed similar lightness values in all groups. The best thickness/opacity combinations for masking discolored dental substrates were LT and MO ceramic veneers with 1.2-mm thickness. Dentin-shade composite resin veneers with a thickness of 0.7-1.0 mm showed good ability to mask discolored dental substrates.

Use of auxiliary devices during retreatment of direct resin composite veneers.

The removal of direct composite veneers, when the retreatment is necessary, represents a challenge to the clinician, since the healthy dental structure must be preserved. Thus, the aim of this study was to compare the accuracy provided by different auxiliary devices during retreatment of direct composite veneers. Seventy-five bovine teeth were prepared for direct composite veneers, scanned (T1), and restored. Specimens were divided into 5 groups for retreatment: conventional high-speed handpiece without auxiliary device (WD); high-speed handpiece with a white LED (WL); high-speed handpiece with an UV light (UL); electric motor and multiplier 1/5 handpiece (EM); and conventional high-speed handpiece using magnifying loupe (ML). After retreatments, other scanning was performed (T2). Changes on dental wear or composite residues areas, as well as, the average between wear and presence of residues were measured. Data were submitted to Kruskal-Wallis and Dunn’s post-test (p≤ 0.05). There were greater areas of wear for ML, being statistically superior to WD and EM groups. The ML presented smaller residues areas, being statistically lower than the WD and EM groups. Regarding the average between wear and the presence of resin residues, additional wear occurred after re-preparation, regardless of the group. Magnifying loupe promoted greater areas of wear and smaller areas of resin residues than conventional high-speed handpiece and electric motor. Both techniques using light accessories did not differ from other ones.

Anterior Veneer Restorations - An Evidence-based Minimal-Intervention Perspective.

The goals of this review are (1) to describe the evidence behind the use of ceramics vs composite resin to restore teeth with anterior veneers using a minimally-invasive strategy; and (2) to discuss the choice of materials and techniques for anterior veneer restorations. In recent years new adhesive restorative materials and techniques have been introduced in dentistry, including nanofilled composite resins for direct restorations, new ceramic materials that combine esthetics and strength, and polymer/ceramic materials for indirect restorations that are fabricated chairside using CAD/CAM technology, allowing the dentist to design, mill, and cement the restoration in one session. In spite of the novelty and new technology behind the introduction of new materials, the available evidence that backs some of these materials does not justify their use over similar materials or techniques that have been used by dentists for some years. Notwithstanding the success of laminate veneers and the popularity of new materials and digital techniques, the classical direct composite resin veneer is still very popular among clinicians and taught in dental schools and continuing education courses. Direct composite resin veneers are usually more affordable than indirect veneers, less invasive of the tooth structure, and easier to repair. Current composite resin materials can be finished to a tooth-like appearance, but they are susceptible to alterations of the surface gloss and potential discoloration of the composite resin. On the other hand, the preparation for indirect veneers is generally more invasive and the respective restorations are more difficult to repair. In addition, the esthetic outcome of bonded ceramic restorations still depends on the clinical behavior of the dentin adhesive and resin luting cement used to bond the restoration to the tooth structure. The ultimate goals of any restorative treatment are to restore function and esthetics, prevent recurrent caries lesions and bacterial leakage into the pulp space, save tooth structure, and promote the well-being of our patients. The armamentarium of new dental materials for esthetic clinical procedures has increased exponentially in the last few years. The use of different materials and techniques for anterior veneer restorations must be based on sound evidence rather than on the marketing hype or testimonials.

Type IV hypersensitivity associated with restorative materials: Clinical report and systematic literature review

Statement of problemType IV hypersensitivity reactions (Type IV HR) are immune responses mediated by antigen-specific effector T cells. PurposeThe purpose of this clinical report and systematic review was to report the clinicopathological features of Type IV HR in the oral mucosa and to present a systematic literature review of case reports and case series of individuals with Type IV HR in the oral mucosa related to contact with dental materials. Material and methodsThe presented clinical lesions were melanotic macules with burning that affected the internal labial mucosa in contact with composite resin veneer crowns. Histopathological and immunohistochemical analysis of the lesion was performed. The systematic literature review was performed based on a search in 4 electronic databases (PubMed/MEDLINE, Scopus, Web of Science, and Ovid). ResultsImmunohistochemistry showed positivity for CD4, CD8, CD20, CD3, tryptase, and CD117. After conservative treatment, the patient reported improvement of symptoms, and a decrease in the number of inflammatory cells was verified. Twenty-one articles were included in the review. Unlike the present patient, the authors of all the articles recommended radical treatment with the removal of the dental material. ConclusionsType IV HR in oral mucosa is rare, and the assessment of clinical and histopathological characteristics is essential to perform an accurate diagnosis and provide appropriate treatment.

Influence of material type, thickness and storage on fracture resistance of CAD/CAM occlusal veneers

ObjectivesThe present study aimed to evaluate the effect of restoration thickness, CAD/CAM material, and 6 months of artificial saliva storage on the fracture resistance of occlusal veneers. Materials and methodsA total of 84 intact maxillary molars were sectioned 4.0 mm occlusal to the cementoenamel junction to expose the dentine. The teeth were assigned into 3 main groups according to the type of restorative material (e.max CAD, Vita Enamic, and Lava Ultimate). In each group, the teeth were allocated into 2 subgroups (n = 14) according to restoration thickness (1.0 and 1.5 mm). The veneers were adhesively bonded using dual-cure self-adhesive luting agent. A total of 42 specimens comprising half the tested subgroups were stored in distilled water for 24-h before the test. The remaining half was stored in artificial saliva at 37 ± 1 °C in an incubator for 6 months. All specimens (n = 84) were subjected to 5000 thermal cycles between 5 and 55 °C ± 2 before the fracture resistance test. The maximum force at fracture was recorded in Newton. Failure mode was analyzed using a stereomicroscope. The results were analyzed using a parametric Three-way ANOVA test. ResultsThe results of the Three-way ANOVA test revealed that material type and restoration thickness significantly affected fracture resistance values (p < 0.5), while 6 months of storage in artificial saliva had no significant effect on mean fracture resistance values (p˃0.5). The most common failure patterns in CAD/CAM resin composite and polymer-infiltrated ceramics were scores I and score II. For glass ceramic groups, score IV and III were more dominant. ConclusionsAll the tested CAD/CAM restorations in both thicknesses exhibited fracture resistance values exceeding normal and parafunctional bite forces. Polymer-infiltrated ceramics and CAD/CAM resin composite veneers showed more favorable fracture patterns.

Anterior teeth rehabilitation with direct resin composite veneer using multiple layering technique: A case report

Cosmetic veneer has become a popular option for patients seeking to improve aesthetic in their smile. The procedure can be done through a direct or indirect technique which differs in term of material used and laboratory involvement. Despite producing a better aesthetic result than its direct technique counterpart, high-cost treatment, multiple visit requirement and invasive nature of tooth preparation are proven to be a stumbling block to the patient in some cases to choose indirect technique. Therefore, direct composite veneer technique can be offered due to its low costing and conservative concept which advocates more tooth structure preservation. This case report is about direct composite veneer for anterior teeth rehabilitation and its simple and conservative protocol.

Direct restorative approach with composite resin in a discolored tooth

Aim: This case report aimed to discuss the clinical sequence and the indications of the direct veneer technique with composite resin to mask a discolored tooth. Case report: A 18-year-old male patient attended a Dental School for treatment of the maxillary central incisors. During the initial examination, the patient reported a dental traumatism in childhood fracturing both teeth. Tooth 21 had already been endodontically treated, and the patient complained of the darkened color, while tooth 11 had been fractured for a long time. Results: Poor class IV composite resin restoration was found, showing rests of endodontic material on tooth 21 and class IV dental fracture on element 11. The elements were cleaned, restorative materials were removed and composite resin veneers were made using a silicone guide technique. Finishing and polishing were performed in the next session, reproducing some of the peculiar characteristics of young teeth, consistent with the patient's age, such as macro and microtextures. Conclusion: The use of direct veneers in composite resin proved to be efficient to restore the aesthetics of darkened and fractured teeth, restoring aesthetic satisfaction through the transformation of the patient's smile.

Advanced polymerization system of photoinitiators in dental materials for aesthetic-functional restoration: case report

Introduction: In restorative dentistry, the faceting of teeth with aesthetic compromise is considered an effective procedure in which the clinician must choose the ideal treatment and select appropriate materials to obtain satisfactory and predictable aesthetic results. In this sense, the use of the Advanced Polymerization System (APS) has advantages, such as aesthetics, durability, degree of conversion and minimal color change. Objective: Demonstrate the aesthetic-functional restoration using adhesive system and composite resin with APS polymerization technology. Case report: A female patient attended the Integrated Clinic of the Faculty of Dentistry of UFRJ with a complaint of blackening of teeth related to ceramic laminates. After clinical and radiographic examination, it was decided to use composite resin veneers. Results: The composite resin veneers associated with the adhesive system promoted an excellent aesthetic result. Conclusion: The improvement of direct restorations with acid etching techniques and the use of new adhesive systems, combined with the constant development and scientific improvement of composite resins, enabled dentists to perform restorations in the most diverse clinical indications.

Faceta direta em resina composta como técnica restauradora minimamente invasiva para harmonização do sorriso

Introdução: São diversos os fatores que podem ocasionar problemas que afetam a estética oral e, entre eles, a ausência de harmonia entre a forma, o alinhamento e a disposição dos dentes anteriores se apresenta como um dos mais frequentemente observados, intensificado pelo escurecimento dental. Objetivo: Relatar um caso clínico, no qual foi utilizada a técnica operatória direta de facetas estéticas em resina composta como alternativa de tratamento restaurador para dentes anteriores, após o tratamento ortodôntico insatisfatório sob o ponto de vista estético. Relato de caso: Paciente jovem, 23 anos, gênero masculino, leucoderma, compareceu à Faculdade de Odontologia da UFRJ, queixando-se do seu sorriso, principalmente em relação à estética dos elementos dentários superiores anteriores. Ao exame clínico, observou-se uma discrepância na proporção do tamanho entre os incisivos centrais superiores e os incisivos laterais. O plano de tratamento consistiu na realização de facetas em resina composta, seguindo o protocolo de recomendação de ácido fosfórico e sistema adesivo, segundo as normas do fabricante. Conclusão: As facetas diretas em resina composta representam uma excelente opção, uma vez que os compósitos resinosos nanotecnológicos são capazes de mimetizar de forma natural, confiável e segura a estrutura dentária, através de uma técnica minimamente invasiva, permanecendo satisfatórias por um longo tempo e apresentando excelente custo benefício.

No-Prep Semidirect Composite Resin Veneer. A Step-by-Step Case Report in a Deciduous Canine with a One-Year Follow-Up

The presence of deciduous canines in adulthood may be of aesthetic concern for patients. Many clinical alternatives include surgical and orthodontic treatment. Since patients search for highly esthetic results and more conservative alternatives, the present clinical report describes a treatment for deciduous canine through an indirect composite resin veneer and an indirect composite resin fragment restoration in a premolar to improve esthetic outcomes with a one-year follow up.

Effect of Surface Treatment With Er:YAG and CO2 Lasers on Shear Bond Strength of Polyether Ether Ketone to Composite Resin Veneers.

Introduction: Polyether ether ketone (PEEK) has low surface energy and high resistance to chemical surface treatments. Therefore, different surface treatments such as laser conditioning should be investigated. There is a gap of information regarding the efficacy of laser irradiation in the surface treatment of PEEK, and the efficacy of several laser types needs to be evaluated for this purpose. This study aimed to assess the effect of surface treatment with erbium-doped yttrium aluminum garnet (Er:YAG) and carbon dioxide (CO2) lasers on shear bond strength (SBS) of PEEK to composite resin veneers. Methods: In this experimental study, 60 rectangular-shaped PEEK samples (7 x 7 x 2 mm) were used. The samples were mounted in auto-polymerizing acrylic resin in such a way that only one surface measuring 7x7 mm remained exposed. The samples were then randomly divided into 3 groups (n=20) of control, Er:YAG laser surface treatment (Power=1.5 W, energy density=119.42 J/cm2 , irradiation time=20 s) and CO2 laser surface treatment (Power=4 W, energy density=159.22 J/cm2 , irradiation time=50 s). The bonding agent and PEEK opaque were applied on the surface of samples and they were veneered with a composite resin using a hollow plastic cylinder with an internal diameter of 4 mm. The SBS was then measured and the data were analyzed using one-way ANOVA, Tukey HSD test and Dunnett's test at 0.05 level of significance. Results: The SBS of the 3 groups was significantly different (P<0.001). The Tukey HSD test revealed that the Er:YAG laser had higher SBS than the CO2 laser group (P<0.001). The Dunnett's test showed that both Er:YAG and CO2 laser groups yielded higher SBS than the control group (P<0.001). Conclusion: The Er:YAG and CO2 laser treatments can increase the SBS of PEEK to composite resin veneers, although the Er:YAG laser seems to be more effective for this purpose.

Smile in an hour with COMPONEER

This case report describes the step-by-step procedures of clinical cases using prefabricated composite resin veneers (COMPONEER), manufactured with the Brilliant New Generation composite resin (Coltene, Altstatten, Switzerland). Direct composite veneers presented some drawbacks such as the difficulty of execution and color instability of the composite resin over time. The simplified application of the has been introduced as an interesting alternative in cases of smile asymmetry, large deficient restorations and discoloured teeth. The treatment with COMPONEER Brilliant NG yielded excellent aesthetic results. COMPONEER is simpler than direct composite veneer technique. The specific characteristics of the system can promote the results with greater aesthetic longevity. It is important to highlight that this procedure does not replace the already established veneer technique with dental ceramics.

Aesthetic restoration using composite resin in teeth with inactive carious lesions: a conservative and predictable approach

ABSTRACT The importance of correct diagnosis, planning and treatment of dental spots is extremely important during aesthetic rehabilitation. Aesthetic requirements have become increasingly common in current society, and direct composite resin restorations are indicated due to the great advancement and increasing improvements of adhesive systems and composite resins. This work presents the clinical case of an oral aesthetic rehabilitation involving direct composite resin veneers associated with dental bleaching. The patient CSM, female, 21 years old, without systemic diseases, attended the dental clinic of the Morgana Potrich Eirelli College (FAMP) complaining of the unsatisfactory aesthetic appearance of her teeth. After careful anamnesis and detailed intraoral and extraoral examination, we identified the presence of a white spot on the upper anterior teeth. The spot was smooth and shiny, did not have soft tissue, and was well delimited and located in the cervical region. These characteristics led to the diagnosis of inactive carious lesions in the facial surface of the upper anterior teeth. After the treatment planning and its approval by the patient, the treatment started. The composite resin veneers associated with dental bleaching were indicated for better aesthetic results. The results achieved were satisfactory and met the patient’s aesthetic requirements by means of a correct diagnosis, study, and adequate planning for the case.

Replacing failed composite resin veneers with ceramic veneers: a case report

Replacing failed composite resin veneers with ceramic veneers: a case report

Microhardness, Color Stability and Microstructural Analysis of Prefabricated Composite Resin Veneers

AbstractThe aim of the work was to determine Knoop microhardness (KH), color stability (ΔE00) and microstructure of prefabricated composite resin veneers (PCRVs). Two PCRVs systems (Componeer Brilliant New Generation, Coltene, Altstätten, Switzerland; and Direct Veneer, Edelweiss, Wolfurt, Austria) were tested. KH was measured at the buccal surface of the PCRVs. Color analyze was evaluated by a spectrophotometer and ΔE00 calculated using CIEDE2000 formula. Microstructure of the PCRVs was characterized using scanning electron microscopy (SEM). Data of KH and ΔE00 were subjected to One-way ANOVA followed by Tukey post hoc test (α=0.05). Componeer (KH = 46) and Edelweiss (KH = 43) presented statistical similar hardness results (p&gt;0.05). Componeer (ΔE00water= 0.1 and ΔE00coffee= 13.4) showed lower ΔE00 than Edelweiss (ΔE00water= 0.5 and ΔE00coffee= 18.7). SEM-images indicated similar microstructures of the PCRVs tested. Although PCRVs present similar microhardness and microstructure, Componeer showed higher color stability and lower extrinsic pigmentation to coffee in comparison to Edelweiss. Direct composite resin veneer treatment might be simplified with PCRVs. However, the high pigmentation observed in the PCRVs could generate aesthetic failures over the time.Keywords: Microscopy, Electron, Scanning. Color. Dental Veneers.ResumoO objetivo do trabalho foi determinar a microdureza Knoop (KH), estabilidade de cor (ΔE00) e a microestrutura de facetas de resina composta pré-fabricadas. Os sistemas de facetas Componeer e Edelweiss foram testados. Para cada sistema, a microdureza foi avaliada na superfície vestibular das facetas. A análise da estabilidade de cor foi feita mediante o emprego de um espectrofotômetro e a alteração de cor foi calculada seguindo a fórmula determinada pelo CIEDE2000. A microestrutura dos sistemas foi observada e caracterizada a partir de um microscópio eletrônico de varredura. Os resultados de microdureza e alteração de cor foram submetidos a análise de variância de um fator complementados pelo teste de Tukey (α=0,05). Os sistemas de facetas pré-fabricadas de resina composta apresentaram valores estatisticamente similares de microdureza (p&gt;0,05). O grupo Componeer apresentou uma alteração de cor inferior em relação ao grupo Edelweiss. Os dois sistemas apresentaram uma elevada pigmentação após imersão em solução com café. A microestrutura dos sistemas se mostrou similar em função da avaliação das imagens em microscopia. Apesar dos sistemas apresentarem microdureza e microestrutura similares, o sistema Componeer gerou menor alteração de cor com menor pigmentação a bebida corante empregada em comparação ao sistema Edelweiss. A técnica de facetas dentárias pode ser simplificada utilizando um sistema de facetas pré-fabricadas de resina composta. Todavia, a elevada pigmentação observada no presente estudo deve ser levada em consideração já que o tratamento com esse tipo faceta tende a ser um procedimento estético com durabilidade elevada.Palavras-chaves: Microscopia Eletrônica de Varredura. Cor. Facetas Dentárias.

A facially driven complete-mouth rehabilitation with ultrathin CAD-CAM composite resin veneers for a patient with severe tooth wear: A minimally invasive approach

The development of technologies that include face scanning and dental software has improved workflows in dentistry. Digital files make it possible to create a 3-dimensional virtual image of the patient that helps the clinician plan treatment and make decisions, reducing uncertainty and improving communication. This report describes the complete-mouth rehabilitation of a patient with severe tooth wear. The treatment adopted a minimal intervention approach, applying adhesive veneers in areas where the tooth structure was affected and used a computer-aided design and computer-aided manufacturing (CAD-CAM) workflow to prepare nanoceramic composite resin materials with a high filler loading.

Reshaping a retained deciduous canine with a semidirect composite resin veneer: A clinical report

The presence of a retained primary canine in an adult, although not frequent, affects esthetics. Choosing the optimal restorative treatment is a challenge. The present clinical report describes a treatment for tooth reshaping with a semidirect composite resin technique, achieving an excellent esthetic result. The treatment was successful at the 18-month follow-up.

Fatigue and fracture resistance of minimally invasive ceramic and resin composite veneers with different designs bonded adhesively to severely eroded teeth

This study evaluated the load bearing capacity of minimal invasive restoration alternatives on severely worn teeth after cyclic loading. Sound human maxillary incisors (N = 72, n = 9 per group) were randomly divided into nine experimental groups to receive one of the following restoration types: Group 1: Intact tooth, Group 2: Direct resin composite, Group 3: Lingual: Indirect resin composite, Labial: Ceramic veneer with lingual overlap, Group 4: Lingual: Indirect resin composite with lingual overlap, Labial: Ceramic, Group 5: Lingual: Direct composite, Labial: Ceramic, Group 6: Lingual: Feldspathic Ceramic, Labial: Feldspathic ceramic, Group 7: Lithium disilicate crown, Group 8: Metal-ceramic crown. Teeth were prepared simulating erosion/wear conditions. Specimens were subjected to cyclic loading (1,200,000 cycles, 5–55 °C) and then loaded to failure from the lingual surface at 105° inclination (1 mm/min). Data (Newton) were analyzed using one-way ANOVA, Tukey`s tests and Weibull moduli were calculated (α = 0.05). Significant differences were observed between the groups for the initial (p = 0.006) and maximum fracture load (p = 0.002). Group 3 (55 ± 36) presented significantly lower initial fracture load compared to other groups (79 ± 35–134 ± 36) (p < 0.05). When maximum fracture load is considered, control group (1) (602 ± 355) and from restored groups 2 (449 ± 144) and 4 (495 ± 291) showed significantly higher results (p < 0.05). Weibull modulus for the maximum fracture load was the highest for Group 2 (m = 3.47) among all groups (m = 1.61–4.18). Groups 2, 3, 6 presented the highest incidence of repairable failures. Based on the results, severely worn teeth could be restored with lingual direct resin composite and labial veneering with indirect resin with overlap.

Indirect Restorations and Fixed Prosthodontics: Materials and Techniques Used by General Dentists of New Zealand.

Background To investigate the selection and use of materials and techniques for core buildup, indirect restorations, and fixed prosthodontics by general dentists in New Zealand. Methods A questionnaire comprising 19 sections and 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected from the Dental Council of New Zealand's 2016 register. Results The majority of the respondents (68.8%) reported using resin composite light-cured materials for the core buildup of vital posterior teeth. A large number of respondents (52%) did not use dentine pins, with the majority of them (25%) being recent graduates (<10 years). Fibre posts were used by 61.6% of the dentists surveyed. The majority of dentists (54.6%) reported using addition-cured silicone impression material for crown and bridge impressions. Glass-ionomer cements (37.5% of participants) and resin-modified glass-ionomer cements (35.8%) were the most common luting cements used. Direct resin composite veneers were the preferred material of choice rather than indirect restoration of anterior teeth (40.4%). Conclusions The study showed that New Zealand dentists surveyed are using current state-of-the-art materials and techniques, with their choice of material being greatly influenced by clinical indications and patients aesthetic demands.

Aesthetic recovery of the smile using a simple and effective application of prepolymerized composite veneers

Introduction: The prefabricated composite resin veneers are prepolymerized laminates of composite that appeared in the market to simplify the restorative procedure, reducing working time. They are extremely thin veneers fabricated in several sizes, which allows performing restorations with high aesthetic standardin anterior teeth using a minimally invasive technique. Objectives: This study aimed to show the use of prefabricated resin veneers in the re-anatomization and recovery of dental aesthetics of a young patient with history of fracture and darkening of anterior teeth after aesthetic periodontal surgery. Case report: Thepatient attended the clinic with a smile complaint and the clinical examination showed tooth 11 with cervical fracture, tooth 21 with color change and caries infiltration, and tooth 22 with inclination of the distal surface toward the palatal region. As treatment, was opted for the use of prefabricated composite resin veneers. Conclusion: The aesthetic results of this case were highly satisfactory, especially when compared with clinical time, cost, and the laboratory work of ceramic veneers, showing the quality and advantages of this material.