Direct Composite Veneers Research Articles

Three-year Follow-up of Conservative Direct Composite Veneers on Eroded Teeth.

This clinical case describes an esthetic rehabilitation of a young patient presenting with erosive tooth wear. The etiological factors for the erosion in this clinical case was excessive carbonated beverages and lemon water intake. The patient's main complaint was the yellowish aspect of her smile. The treatment procedure selected was direct resin composite veneers in the six maxillary anterior teeth. A three-year follow-up of the case is presented. The three-year follow-up showed a successful clinical performance of the treatment procedure after a finishing/polishing protocol.

MANAGEMENT OF TURNER’S TOOTH

Management of Turner’s tooth using direct composite veneer. Enamel hypoplasia may be dened as an incomplete or deformative formation of the organic enamel matrix of the teeth. Turner’s dysplasia or Turner’s tooth is a type of enamel hypoplasia caused due to local infection or trauma; the incidence of this hypoplasia being 46.08% [1]. Hypoplasia results only if the injury occurs during the time the teeth are developing, formative stage of enamel development. There is no treatment except of cosmetic appearance. Different treatment modalities such as crowns or veneers can be attempted depending upon the degree of hypoplasia. The clinician needs a balanced treatment protocol to make a decision on a complete review of the case. In the following paper, we present a clinical case report of aesthetic management of Turner’s tooth.

The Ability of Two Chewing Simulation Devices in Emulating the Clinical Deterioration of Anterior Composite Restorations in Severely Worn Teeth.

This study investigated the ability of two chewing simulation devices to emulate in vitro the clinical deterioration observed in anterior composite restorations in severe tooth-wear patients. Advanced tooth wear was simulated in bovine incisors, which were restored with palatal and buccal direct composite veneer restorations. The incisal edges of restorations were subjected to 960K cycles of either compressive loading (Biocycle-V2; 125 N at 2 Hz) or wear and mechanical loading (Rub and Roll; 30 N at 20 rpm). Surface degradation was rated using FDI scores to compare the chewing devices (Fisher's test, a = 0.05). Topography and deterioration of restorations was analyzed using SEM. The ability to emulate the deterioration was investigated by comparing the surface degradation observed in vitro with the clinical degradation observed in restorations placed in severe tooth-wear patients after 3.5 years. Distinct degradation patterns were observed between the simulation devices: Biocycle-V2 generated deterioration that was not comparable to the clinical situation, including contact damage, minor wear, and localized roughening. The degradation caused by Rub and Roll was more similar to the in vivo situation, including wear facets, chipping, delamination, staining, and marginal ditching. The FDI scores were different between the chewing devices for surface/marginal staining, material/retention, and marginal adaptation (p = 0.003). SEM analysis showed microcracking at the interface between composite layers at the incisal edges. The Rub and Roll chewing device was able to emulate the clinical deterioration observed in anterior restorations in severe tooth-wear patients and thus may be used as an oral-cavity simulation method, contributing to translational research.

Esthetic and Functional Rehabilitation of a Patient with Amelogenesis Imperfecta Using Adhesive and Non-Invasive Techniques: A Case Report

Introduction: Limited evidence is available on adhesive dentistry in the management of amelogenesis imperfecta (AI). The presentation, the conservative management with adhesive techniques, and the outcome of hypoplastic AI are discussed. Case Report: Autosomal dominant, hypoplastic AI was diagnosed, on a 36-year-old woman, presented with unesthetic teeth and a history of frequent decay with subsequent complications. Following the hygienic phase, stabilization of caries and root canal treatment (RCT) were done. Coronal restoration of endodontically treated teeth and light-cured direct composite veneering were done in the restorative phase. Surveyed crowns, mucosa-borne partial denture, and a resin-bonded bridge were prescribed in the prosthetic phase. The patient was pleased with the improved masticatory ability and esthetics. Discussion: A stepwise least invasive, yet esthetically acceptable treatment options based on adhesive techniques are successful in hypoplastic AI.

Adhesive Management of Anterior Tooth Wear in Combination with the Dahl Concept—A 27-Month Observational Case Series

Localized anterior maxillary tooth wear caused by erosion and attrition with loss of interocclusal space is difficult to manage. This observational case-series study reports six cases with worn anterior dentition treated with labial ceramic and palatal direct resin composite veneers at an increased vertical dimension of occlusion without restoration of unaffected posterior teeth. Thirty-six palatal direct veneers were made in six patients from a nanohybrid resin composite with the help of a wax-up-based template at an increased vertical dimension. After the complete re-establishment of posterior occlusion, 40 labial lithium-disilicate ceramic veneers were fabricated with a mock-up-guided method. The sandwich veneers were evaluated according to the United States Public Health Service (USPHS) criteria after a mean service time of 22.7 months. Re-establishment of posterior contacts as well as subjective patient satisfaction and function were evaluated. The overall success of the labial ceramic veneers was excellent. The quality of the palatal resin composite restorations was found to be good with predominantly "Alpha" scores. The marginal quality (11.1% and 33.3% of integrity and discoloration, respectively) and surface roughness (16.7%) showed small deteriorations indicated by "Beta" scores. The resin composite showed, in general, signs of wear facets which resulted in "Beta" scores in 44.4% of the cases. Posterior contacts re-established firmly within 4 weeks in all cases. Patient satisfaction with esthetics and function was high. The short-term outcome of this non-invasive treatment option is favorable and promising.

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.

English

An unpleasant smile can have a psychosocial effect leading to lack of self-esteem and a challenge in social relations. A perfect smile is a balance among 3 parameters: the white (teeth), the pink (gum) and the lips. A predictable smile correction warrants a multidisciplinary approach and good treatment planning. We planned for a minimally invasive interdisciplinary treatment approach for the restoration of a gummy smile with dental fluorosis in a young female patient. An interdisciplinary management of smile correction is crucial for successful results. Lasers for soft tissue management and minimal tooth preparation for direct composite veneer restorations being minimally invasive periodontal and restorative approaches were the key to success with exceptional patient satisfaction. Minimally invasive procedures in interdisciplinary dentistry should be embraced in the management of procedures requiring correction of both hard and soft tissues, for successful outcomes. Pre-treatment mock-up can build patients' confidence in dentistry and are useful tools for planning treatments with a predictable outcome. A beautiful smile is the fruit of a coordinated and balanced interplay between teeth, gingiva and lips. A compromise in any of these cornerstones can impair the beauty of a smile. Thorough knowledge and understanding about the various elements involved and their harmonious synchronisation makes smile makeovers a challenging task. One such challenge is the treatment of gummy smile. A gummy smile is a clinical condition that has gained tremendous focus and attention recently. Gummy smile is the excessive gingival display when a person smiles. It has been defined as a nonpathological condition causing aesthetic disharmony in which more than 3 mm of gingival tissue is exposed while smiling.1 Aetiology of a gummy smile can be multifactorial and the main factors being altered passive eruption (APE), vertical maxillary excess and upper lip hypermobility. The diagnosis must be accurate to deliver the appropriate line of treatment. Based on the complexity of the underlying aetiological factors involved, the treatment modalities also change from conservative approaches like aesthetic restorations and orthodontic tooth movements to periodontal and maxillofacial surgical procedures.2 Altered passive eruption (APE) also knows as “impaired passive eruption” is a clinical condition characterised by the coronally positioned marginal gingiva in relation to the cementoenamel junction (CEJ). Passive eruption is a physiological phase involved in the process of tooth eruption. As the teeth meet the occlusal plane, the soft tissue covering the teeth migrates apically till the CEJ is reached. Retardation in this process causes failure of the gingiva to migrate apically, resulting in short clinical crowns and excessive soft tissue exposure while smiling. This is visualised as a gummy smile.

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.

The effect of toothbrush abrasion on wear and surface roughness of direct and indirect composite laminate veneer restorations

Direct and indirect composite laminate veneers have been frequently used, however the wear of composite restorative materials is still a major problem. Objective: This study aimed to investigate the surface roughness and wear of composite laminate veneers made by two different methods after toothbrushing simulation. Material and Methods: Ninety-six upper incisors and canines were divided into two groups: 1-Componeer prefabricated composite veneer (CPV), 2- Uveneer direct composite veneer (UDV). At the UDV group, restorations were made by using Uveneer template system with the same nanofilled composite material (Synergy D6, Coltène, Altstatten, Switzerland) of the prefabricated Componeers’. The initial surface roughness was measured with a profilometer, then the weight was measured. Before the simulation, samples were screened with a 3D extra-oral scanner. Toothbrush simulation was performed at 10,000 rotational strokes with 2.5 N. The measurements were repeated after toothbrushing simulation. Data were analyzed using variance analyses and t-tests (p < 0.05). Results: Before and after polishing, a significant difference was found between two groups’ surface roughness in both lateral incisors (p = 0.000, p = 0.000) and canines (p = 0.048, p = 0.001), respectively. After toothbrushing simulation, significant increases were observed in central and lateral incisors’ surface roughness with two methods. There was no significant difference between weight loss (p > 0.05). In 3D scans, wear rate was quite similar except UDV group central incisors. Conclusions: Surface roughness of the CPV restorations were less affected after toothbrushing simulation. However, the Uveneer template system, a facilitated treatment procedure compared to the manual buildup of direct restoration, has shown comparable results with CPV’s.

Influence of various antioxidants on micro-shear bond strength of resin composite to bleached enamel.

Teeth bleaching causes an immediate decrease in resin composite bonding ability. This study aimed to investigate the influence of various antioxidants on resin composite bond strength to bleached enamel. One hundred and ten human maxillary incisors were used. A negative control (group A) (n = 10) was assigned (no bleaching-no antioxidant). The remaining teeth were divided into two groups (n = 50) according to the bleaching agent used: group B (40% hydrogen peroxide) and group C (35% carbamide peroxide). Both groups were subdivided into five subgroups (n = 10). A positive control subgroup (no antioxidant) and other four subgroups according to the antioxidant solution used (10% sodium ascorbate, 10% grape seed extract, 10% green tea extract, and 5% alpha-lipoic acid). After resin composite building, the micro-shear bond strength test was performed. Fracture analysis was examined using a stereomicroscope. Statistical analysis was performed using a two-way analysis of variance and Tukey's HSD post hoc test. Bond strength significantly decreased after bleaching and there was no significant difference between bleaching agents (P < .0848). Except for alpha-lipoic acid subgroups, the other antioxidants subgroups revealed significantly higher bond strengths than bleached control subgroups (P < .0001). All antioxidants used except alpha-lipoic acid were effective in the reversal of compromised bonding after bleaching. Immediate bonding procedures after bleaching are requisite when bleaching fails to treat teeth discoloration and the direct composite veneer is considered, also when shades of old composite restorations become mismatched after bleaching and should be replaced. Immediate reestablishment of resin bond strengths after bleaching can be achieved by using several antioxidants without the need for delay.

Analysis of results of treatment of patients with discolored teeth using different types of lumineers and composite veneers

The aim of the studywas to study the results of treatment of patients with discolored teeth using various types of lumineers and composite veneers.Materials and methods.The study involved patients with discoloration of the teeth who underwent dental treatment: in group I (n = 10) – using lumineers made of ceranite ceramics, in group II (n = 10) – using modified lumineers made from lithium disilicate, in the group III (n = 20) – using composite veneers. The duration of follow-up after treatment was 24 months.Results.According to the results of a two-year observation, and analysis of the effectiveness of treatment using lumineers made of ceramite ceramics Lumineers by Cerinate (USA), using modified lumineers made of lithium disilicate IPS e.max Press (Liechtenstein) and using IPS Empress direct (Liechtenstein) composite veneers was higher in the group using lumineers compared to composite veneers, but these differences were not statistically significant. Also, there were no statistically significant differences when using lumineers made of ceranite ceramics and modified lumineers made of lithium disilicate.

A CLINICAL EVALUATION OF DIRECT VENEERS MADE WITH TWO TYPES OF COMPOSITES

Objectives: the aim of this study was to provide a retrospective clinical evaluation of direct composite veneers performed with microfilled or universal composites, through two evaluation criteria (FDI and USPHS). Materials and methods: patients should be in compliance with the inclusion criteria: having a composite veneer in anterior teeth made either with microfilled or universal using composites (microhybrid/nanohybrid), conventional dentin-bonding agents and for a minimum of 6 months period in service. A calibrated blind examiner assessed the veneers using the FDI and USPHS criteria and the results were subjected to statistical analysis by the Mann-Whitney test (p<0.05). Results: Twenty-eight patients (mean age 42.9 year-old) and seventy-four composite veneers were examined. The mean period of time in service was three years, with periods varying from six months up to ten years. Three cases of total failure (veneers lost, universal composites group) occurred in the surveyed patients, out of 17 failures in total. In general, the veneers showed a clinical satisfactory outcome (77% survival rate). Concerning the two composite types, better clinical performance was observed for microfilled in relation to surface luster, surface staining, colour match and marginal adaptation. Conclusion: In this interim evaluation, direct composite veneers demonstrated an acceptable clinical behavior. Microfilled composite veneers showed a better performance compared to universal composites. The two criteria (USPHS and FDI) were similar in the clinical evaluation process. Clinical relevance: direct composite veneers have a good clinical performance, microfilled composites are interesting options regarding esthetic properties.

Clinical evaluation of "componeers" and direct composite veneers using minimally invasive enamel preparation technique: In vivo study.

Aim:The aim of this study was to evaluate the clinical behavior of prefabricated componeers and direct composite veneering. The objective of the study was to compare the changes in color, surface texture, marginal integrity, and gingival response for componeers and direct composite veneers.Settings and Study Design:This was an in vivo, comparative study.Materials and Methods:Ten patients indicated for anterior veneers were selected and divided into Groups A and B of five patients each. Group A was restored with componeers and Group B with direct composite veneers. Both the groups were compared for color changes, surface textural changes, marginal integrity, and gingival response, starting immediately post veneering and at 3, 6, 9, and 12 months subsequently.Statistical Analysis Used:Friedman's two-way analysis of variance and Mann–Whitney test were used for statistical analysis.Results:Results for color ranged from excellent to good with minimal color changes post veneering. Overall, “gingival response,” in both the groups, showed statistically significant differences in mean rank scores (P ≤ 0.05). The data depicted an improvement in gingival response for all patients during the period of the study. Surface textural changes were significant only for maxillary right canine and maxillary left lateral incisor (P = 0.024 and 0.039, respectively) in both the groups. Maxillary right canine in both the groups showed significant changes in marginal integrity. Intergroup comparison of gingival response, surface texture, and marginal integrity depicted no significant difference between the groups (P > 0.05).Conclusions:This study concluded that the intergroup comparison of componeers and direct composite veneers for the parameters, gingival response, surface texture, and marginal integrity did not depict any significant differences. Both the groups displayed minimal changes in color, surface texture, and marginal integrity and improved gingival response.

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.

The Effectiveness of Using Direct Composite Veneer Template System in Restoring Anterior Teeth

Background: Veneer is one method of dental restoration. Veneers are used to repair tooth deformities, discolorization, diastema, and fractures. One method of veneers is direct composite veneers. However, it is difficult to form a perfect labial surface using this technique.Method: The purpose of this study was to identify the effectiveness of direct composite veneers template. The type of the experiment was quasi-experimental with the post-test only design. The area of interest was the dental practice in Palembang City, with total sample equals to the population of dentists who do the direct composite veneer.Results: The average surgery duration of direct composite veneers using plastic, mica stem, and plastic stem were 46.25, 32.25, and 28.00 minutes respectively. The easiness level of conducting direct composite veneer with a plastic template was 3.35 (normal), 4.20 for mica stem template (easy), and 4.30 (easy) for plastic stem template. The satisfaction level of dentists using the plastic template was 3.50 (ordinary), the mica stem template was 4.30 (satisfied), and the plastic stem template was 4.65 (satisfied).Conclusion: The ANOVA analysis results showed a significant difference between the duration, easiness level, satisfaction level when working on different templates of direct composite veneer. It was concluded that the usage of plastic stem template resulted in fastest, easiest, and the most satisfying outcome.

Direct composite veneers -restoring esthetics by procuring patient demand: a case report

Re-establishing a patient’s lost dental esthetic appearance is one of the most important topics for contemporary dentistry. New treatment materials and methods have been coming on the scene, day by day, in order to achieve such an aim. Most dentists prefer more conservative and aesthetic approaches, such as direct and indirect laminate veneer restorations, instead of full-ceramic crowns for anteriors where aesthetics is really important. Laminate veneers are restorations which are envisioned to correct existing abnormalities, esthetic deficiencies and discolorations. Laminate veneer restorations may be processed in two different ways: direct or indirect. Direct laminate veneers have no need to be prepared in the laboratory and are based on the principle of application of a composite material directly to the prepared tooth surface in the dental clinic. Indirect laminate veneers may be produced from composite materials or ceramics, which are cemented to the tooth with an adhesive resin. In this case report, direct composite laminate veneer technique used for patients with esthetic problems is described and six-month follow-up are discussed. As a conclusion, direct laminate veneer restorations may be a treatment option for patients with the esthetic problems of anterior teeth in case similar to those reported here.

Aesthetic Rehabilitation with Nano- Ceramic Composite Material - Case Reports

Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of treatment, patient’s expectations and duration of treatment should be taken into consideration. This article presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with satisfactory outcome that mimic the natural dentition.

Prefabricated direct composite veneer: with and without teeth preparation

Background: Componeer (prefabricated direct composite veneer) is a nano-hybrid composite enamel veneer that combines the advantages of both, placing a direct composite resin and those of a prefabricated laminate veneer manufactured in a laboratory. Any structural defects or anomalies in the anterior teeth or ‘esthetic zone’ create a problem for the patient. Hence, composite laminate veneers focus on targeting such abnormalities where the dentist is in complete control of the outcome, despite the pre-existing color, shape, structure, contours or morphology of the tooth. The aim of the study was to determine the success rate of using prefabricated direct composite veneers for cases with minimal preparation and ‘prep-less’ technique and compare both outcomes for establishing a better and long-lasting restoration.&#x0D; Case presentation: The study presented two case reports, the first case was of a 46-year-old female with major complaints regarding spaces between upper teeth along with yellow discoloration. While the second i.e. Case 2 was of a 23 years old female with generalized spacing in her teeth due to microdontia and her chief complaint was the diastema present in between her upper front teeth. &#x0D; Management and Results: A minimal preparation technique for composite veneering was used in Case 1 to combat the problem of yellow discoloration along with generalized spacing whereas a ‘prep-less’ technique was used for Case 2. Both cases depict different methods of composite veneering and restorations for both minimally prepared or ‘prep-less’ technique showed no differences at the follow-up visit (after 6-month).&#x0D; Conclusion: Composite veneers have shown excellent results for restoring anterior defects while preserving tooth structure and surrounding tissues. It has proven to be the most time-efficient way of restorations meeting the high demands of superior esthetics and cost-effectiveness.

Clinical performance of the composite resin veneers: the minimally invasive approach

Minimally invasive approach lead composite resin veneers restorations as a conservative and alternative treatment option, with the aim to improve the aesthetics anterior dentition. Clinically, this treatment reducing the clinical time and has a lower cost than indirect technique. In addition, new resin composite was developed to support the clinician to make more natural restorations. The present case report aim to evaluated the clinical performance of direct composite veneer technique was restored with 100% supra-nano spherical filler composite. A 39-year-old female, searched for restorative treatment of anterior teeth, which were unaesthetically altered. In the clinical examination, it was observed color alterations in maxillary left and right incisors and canines due to use of medicines, and bruxism. The treatment plan included an in-office dental bleaching, removal of inadequate anterior restorations and confection of composite veneers restorations. The dental bleaching was performed with hydrogen peroxide 35% activated by LED/laser in two sessions. Those restorations were performed using supra-nano spherical resin-based composite, color A1 for dentin and enamel, with direct composite laminate veneer technique. After six-month follow-up, the restorations presented good clinical aspect, absence of biofilm accumulation and abrasive wear. Therefore, direct veneer restorations may be alternative treatment for anterior teeth esthetic problems, suggesting a promising performance of these new composites.Descriptors: Esthetics, Dental; Composite Resins; Dental Veneers.