Indirect Veneers Research Articles

A minimally invasive approach for aesthetic enhancement using indirect composite veneers: A case report

Introduction: Technique of composite veneers fabricated directly on a cast is easier and requires less clinical time and also the survival rates are statistically similar to ceramic veneers. Case Report: Composite veneers can be fabricated directly on a cast using the technique that have been described in this case report. Conclusion: Being inexpensive, less time consuming and having acceptable mechanical properties, indirect composite veneer is a good treatment option for discolored teeth.

Endo-restorative treatment of a severly discolored upper incisor: resolution of the "aesthetic" problem through Componeer veneering System.

Re-establishing a patient's lost dental aesthetic 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 or indirect veneer restorations, instead of full-ceramic crowns for anteriors where aesthetics is really important. The aim of the study is to evaluate clinically the effectiveness of a direct composite veneering system in resolving aesthetic problem of an upper incisor with a multidisciplinary treatment approach. Patient with a severe discolored upper incisor came to our attention; at the X-ray exam there was an evidence of a past not good root canal treatment and also old and incongruent composite obturation. After removing all the material inside the root canal was performed a new correct endodontic filling, then Authors tried to bleach the tooth trough "walking-bleach" technique with a hydrogen peroxide (30 volumes) and sodium perborate solution without excellent results. So it was decided to insert a glass-fiber post and than to perform a direct composite veneer with Componeer System (Coltene). Componeer System is a system of prefabricated composite veneers that are abled to be applied directly in the first appointment: after a conservative preparation of the tooth, it must be used an adhesive agent (for example a "three steps") and then with composite stratification it's possible to apply the componeer veneer (choosing the right measure, modified as necessary) as the last covering aesthetic layer. The evaluation of result of this multidisciplinary treatment was essentially clinical and radiological; in fact it's possible to observe, from a clinical point of view, the good aesthetic aspect of the direct composite restoration with componeer veneer that offers also some advantages: conservative preparation with minimal lost of tooth tissue, easy standardized technique, low cost and immediate restoration of the tooth (without provisional passage). From a radiological point of view it's possible to check the good quality of endodontic retreatment on the post-operative periapical X-ray. To verify the long-term result Authors consider follow up at six months and one year. A multidisciplinary approach is always necessary to program a treatment plan in dentistry; in the case reported Authors decide to perform an endo-conservative treatment with different steps: - root canal therapy to resolve endodontical problem- glass fiber post to reinforce the conservative restoration- direct composite veneer restoration (after bleaching) to obtain the resolution of anterior aesthetic problems.

Integrated approach of ceramic and composite veneers in tetracycline stained teeth: A case report

Abstract Tooth discoloration is one of the most frequent reasons that one seeks dental care. The common causes of tooth discoloration are fluorosis, enamel hypoplasia, tetracycline staining etc. Based on the severity of discoloration, treatment may vary from more conservative treatment like bleaching to more extensive treatments involving full crowns and veneers. The purpose of this article was to report the advanced treatment options and their integrated use for generalized intrinsic discoloration caused by Tetracycline encompassing bleaching to lighten the discoloration followed by Direct and Indirect veneer restorations using Composite resin and Ceramic respectively. How to cite this article Divya KT, Satish G. Integrated approach of ceramic and composite veneers in tetracycline stained teeth: A case report. CODS J Dent 2014;6;45-48

Prefabricated veneers - bond strengths and ultramorphological analyses.

To measure the microshear bond strengths (μSBS) of composite resin to the intaglio surface of prefabricated indirect veneers and analyze the FE-SEM ultramorphology of the pretreated intaglio surfaces as well as the fracture modes. Three veneer systems (veneer and respective luting material) were used in this study: two prefabricated veneer types, Cerinate One-hour (CER, DenMat) and Componeer (CMP, Coltene), and a laboratory- made veneer, IPS e.max Press (IPS, Ivoclar Vivadent) used as the control. For each group, 10 veneers were used. After delimitation of the bonding area with a double-faced adhesive tape, 0.8-mm-diameter cylinders of composite luting material were bonded to the pretreated intaglio surface. After polymerization, the specimens were fractured in shear mode using the wire-loop method in a universal testing machine. The pretreated intaglio surface of two extra veneers and four fractured specimens per group were morphologically characterized using FE-SEM. CER resulted in statistically lower mean μSBS (7.1 ± 1.2 MPa) than the other two veneer systems, CMP (15.2 ± 2.5 MPa) and IPS (14.7 ± 1.7 MPa) at p < 0.0001. As seen with the FE-SEM, the intaglio surface of CMP did not display microretentive features, while multiple microretentions were observed in both CER and IPS after HF etching. Within the limitations of this in vitro study, the CMP and IPS veneer systems resulted in greater bond strengths than those of the CER veneer system.

Effect of tooth brush abrasion and thermo-mechanical loading on direct and indirect veneer restorations

This study investigated toothbrush abrasion and in vitro aging on ceramic (indirect technique) and composite veneers (direct technique). Identical composite and individual human incisors were restored with industrially preformed composite veneers, indirectly produced ceramic veneers, and direct composite restorations. Surface roughness was determined before and after tooth brushing. A 5-year period of oral service was simulated by thermal cycling and mechanical loading (TCML). After TCML, all specimens were examined with microscopy and scanning electron microscopy. Specimens without failures during TCML were loaded until failure. analysis of variance; Bonferroni's post hoc analysis, Kaplan-Meier-Log Rank test (α = 0.05). Tooth brushing yielded a non-significant increase (p = 0.560) in roughness in all materials (industrial veneer, 0.12+/-0.07 μm, direct restoration, 0.18+/-0.14 μm, ceramic, 0.35+/-0.16 μm). No significant differences in roughness could be determined between the materials, neither before nor after testing (p < 0.001). After TCML of artificial teeth, direct and preformed composite veneers on composite teeth showed no failures or damages. Two ceramic veneers showed cracking in the labial area. After TCML of human teeth, transmission microscopy indicated a facial crack in a ceramic veneer and chipping in the cervical area of a preformed veneer. Two direct composite veneers lost retention. No significantly different survival rates were found between the three veneer groups. Fracture force on human teeth varied between 527.8+/-132.4 N (ceramic), 478.3+/-165.4 N (preformed composite), and 605.0+/-263.5 N (direct composite). All materials revealed comparable wear resistance. Indirect ceramic, direct restorative composite, and preformed composite veneers showed comparable failure rates and satisfying longevity. The results indicate similar longevity of the chosen materials for veneer restorations.

A Multidisciplinary Conservative Approach for Esthetic Correction of Anterior Crowding: A Clinical Case Report

y approach to correct severe anterior crowding using the Invisalign appliance, indirect veneers, and direct composite resin bonding to esthetically improve the patient’s smile. The patient was pleased that his smile was corrected in a relatively shor t time with the invisible aligners. Also, the veneer preparations were conservative because the teeth were in proper alignment. Similar cases can be treated with the multidisciplinary approach described to achieve predictable results that have a positive impact on patients’ lives. Am J Esthet Dent 2013;3:264–274. doi: 10.11607.ajed.0080

Direct composite laminate veneers: three case reports.

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 discolo-rations. 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 three patients with esthetic problems related to fractures, discolorations and an old prolapsed restoration, is described and six-month follow-ups are discussed. As a conclusion, direct laminate veneer restorations may be a treatment option for patients with the esthetic problems of anterior teeth in cases similar to those reported here.

Durability of bond between an indirect composite veneering material and zirconium dioxide ceramics

Objective. The purpose of the present study was to evaluate the durability of bond strength between an indirect composite material and zirconia ceramics after thermocycling (100 000 cycles) and to assess the effect of various priming agents for zirconia surface treatments. Materials and methods. A CAD/CAM system (Katana, Noritake Dental Supply) was used to fabricate 96 zirconia disks as a bonding substrate. The specimens were randomly divided into six groups (n = 16) and treated with one of the following acidic priming agents: Alloy Primer (ALP, Kuraray), Clearfil Ceramic Primer (CCP, Kuraray), Clearfil Photo Bond (CPB, Kuraray), Clearfil Photo Bond with Clearfil Porcelain Bond Activator (CPB + Activator, Kuraray), Estenia Opaque Primer (EOP, Kuraray) and Porcelain Liner M Liquid A (PLA, Sun Medical). The specimens were bonded with an indirect composite material (Estenia C&B Dentin, Kuraray). Shear bond strengths were tested before and after 100 000 thermocycles and the data were analyzed by using the Steel-Dwass test and Mann-Whitney U-test. Results. After 100 000 thermocycles, the PLA group showed the lowest bond strength (p = 0.010), whereas the CPB + Activator (23.9 MPa; p < 0.014) and CPB (22.7 MPa; p < 0.028) groups had significantly higher bond strengths than the other groups. The Mann-Whitney U-test revealed that bond strengths did not significantly decrease after thermocycling, except for specimens in the PLA (p = 0.038) and CCP (p = 0.028) groups. Conclusions. Application of a combination of hydrophobic phosphate monomer (MDP) and initiator results in a durable long-term bond between Katana zirconia and Estenia C&B composite material.

In Vitro Evaluation of Shear Bond Strength and Mode of Failure of the Interface between an Indirect Composite Bonded to Fiber‐Reinforced Composite Substructures

Failures of fixed partial dentures (FPDs) fabricated with fiber-reinforced composites (FRCs) have been attributed to veneering fractures. The aim of the present study was to investigate the shear bond strength and mode of failure between an indirect composite and FRC substructures. SR Adoro indirect composite was bonded to the following substructures: (a) flat surface made of unidirectional glass fibers (group A), (b) retentive sticks made of unidirectional glass fibers (group B), (c) flat surface made of fiber net (group C), (d) retentive sticks made of fiber net (group D), (e) nickel-chromium dental alloy (control, group E). For every group, 13 specimens were fabricated. All specimens were hydrothermocycled (5000 cycles, 5°C/30 sec, and 55°C/30 sec). A bond test was performed in a testing machine at a 0.5 mm/min crosshead speed according to ISO 10477. The failure mode was determined by examination of the fractured surfaces under an optical microscope. Selected specimens were examined with scanning electron microscope and with energy dispersive spectroscopy for compositional determination. The morphology (flat-sticks) and the type (unidirectional-net) of fibers on the bond strength were estimated. The mean shear bond strength was significantly different between groups E and A (p= 0.044), and groups A and B (p= 0.010). All FRC specimens showed cohesive failure. Group E showed predominantly adhesive failure. The bond strength was higher when sticks or fiber nets were used. Fiber nets and retentive sticks increase the shear bond strength between FRCs and indirect composite. In FPDs, the morphology and type of FRC substructures might influence the shear bond strength between the FRC substructure and the indirect veneering composite. With the proper design of these substructures, the number of veneering fractures may be decreased.

The impact of in vitro aging on the mechanical and optical properties of indirect veneering composite resins

Flexural strength, hardness, surface roughness, discoloration, and abrasion resistance are important properties of veneering composite resins. Recently introduced veneering resins are purported to have enhanced mechanical properties due to their composition, but their long-term durability is not known. The purpose of this study was to test the impact of aging on 3 different veneering composite resins. Indirect composite resins, GC Gradia, VITA VM LC, and Sinfony were prepared for flexural strength (n=165 per group), Martens hardness (n=10), surface roughness (n=10), discoloration measurement (n=30), and abrasion resistance (n=6) testing. After initial flexural strength measurement, the remaining specimens were stored in water or subjected to thermocycling for 1, 7, 28, 90, or 180 days, and hardness and surface roughness (water stored: n=5 and thermocycling: n=5) were tested. The discoloration specimens were divided into 3 groups: coffee, black tea, and red wine; n=10), and age and discoloration were measured. Abrasion resistance was determined after 120,000, 240,000, 640,000, and 1,200,000 mechanical thermocycling loading. One-way ANOVA was used, followed by a post hoc Scheffé test and t test. The longitudinal observations were analyzed by using linear mixed models (α=.05). When considering all 5 of the properties tested, Sinfony demonstrated the best results, followed by GC Gradia and VITA VM LC. The veneering composite resin, Sinfony, showed the most stable properties.

Esthetics and biocompatibility of composite dental laminates

Background: Advances in modern dental materials provide patients with a choice of natural looking veneers to provide esthetic restorations. These may be directly fabricated composite resin veneers or indirectly fabricated veneers. This study was carried out to evaluate the clinical effect of new generation indirect veneering composites and to compare them with veneers fabricated from direct composite restorations. Methods: The present study was carried out in the Prosthodontics department of a medical college. A total of forty patients requiring restoration of the anterior teeth using composite veneers were selected and either of the two materials was used to fabricate the veneers. Result: Clinical evaluation was done for esthetics and periodontal health. Statistical analysis showed that there were no significant changes to the periodontal health during the period of the study. Conclusion: The evidence obtained from this study indicates that both direct as well as indirect composite materials had clinically acceptable outcomes in terms of restoration of esthetics. Biocompatibility with the periodontal tissues of both materials was also evident by the improvement in oral health indices used in the study.

An indirect veneer technique for simple and esthetic treatment of anterior hypoplastic teeth

This study describes a technique for treating anterior hypoplastic teeth using indirect nanocomposite veneer restoration. The prime advantage of an indirect veneer technique is that it provides an esthetic and conservative result. One of the most frequent reasons that patients seek dental care is discolored anterior teeth. Although treatment options such as removal of surface stains, bleaching, microabrasion or macroabrasion, veneering, and placement of porcelain crowns are available, conservative approach such as veneer preserves the natural tooth as much as possible. Full veneers are recommended for the restoration of localized defects or areas of intrinsic discoloration, which are caused by deeper internal stains or enamel defects. Indirectly fabricated veneers are much less sensitive compared to a operator's technique and if multiple teeth are to be veneered, indirect veneers can be usually placed much more expeditiously. Indirect veneers last much longer than the direct veneers. Therefore, indirectly fabricated veneers are more advantageous than directly fabricated veneers in many cases.

Influence of anatomic reference on the buccal contour of prosthetic crowns

During clinical practice, when performing prosthetic rehabilitation with single crowns, improper reproduction of the dental contour by the dental laboratory is a common occurrence. Therefore, the present study evaluated the fidelity of the reproduction of the buccal contour in an upper left canine performed by three Dental Prosthesis Technicians (DPT) using the indirect laminate veneer technique. First, the DPTs confected the veneers based on a model obtained from the upper arch of a dental dummy, containing a replica of an upper left canine with a prosthetic preparation for a laminate veneer. Then, the same DPTs received other identical models, now with the replica of the upper left canine with no preparation, to be used as an anatomical reference for confecting the laminate veneers. The laminate veneers were then bonded to the plaster models and had their buccal contour individually measured. Measurements were also made of the buccal contour of the reference canine. The data were analyzed by ANOVA and the t-test (p = 0.05). Results showed 100% of buccal overcontour when the laminate veneers were compared to the reference canine, regardless of which DPT confected the veneer and regardless of using or not the anatomical reference. The DPTs who participated in the present study were unable to acomplish a faithful anatomical reproduction of the buccal contour, creating an overcontour in all samples. This situation may be responsible for increasing the probability of periodontal and esthetic harm in clinical practice.

Effect of light-curing method and indirect veneering materials on the Knoop hardness of a resin cement

This study evaluated the Knoop hardness of a dual-cured resin cement (Rely-X ARC) activated solely by chemical reaction (control group) or by chemical / physical mode, light-cured through a 1.5 mm thick ceramic (HeraCeram) or composite (Artglass) disc. Light curing was carried out using conventional halogen light (XL2500) for 40 s (QTH); light emitting diodes (Ultrablue Is) for 40 s (LED); and Xenon plasma arc (Apollo 95E) for 3 s (PAC). Bovine incisors had their buccal face flattened and hybridized. On this surface a rubber mold (5 mm in diameter and 1 mm in height) was bulk filled with the resin cement. A polyester strip was seated for direct light curing or through the discs of veneering materials. After dry storage in the dark (24 h 37 degrees C), the samples (n = 5) were sectioned for hardness (KHN) measurements, taken in a microhardness tester (50 gF load 15 s). The data were statistically analyzed by ANOVA and Tukey's test (alpha = 0.05). The cement presented higher Knoop hardness values with Artglass for QTH and LED, compared to HeraCeram. The control group and the PAC/Artglass group showed lower hardness values compared to the groups light-cured with QTH and LED. PAC/HeraCeram resulted in the worst combination for cement hardness values.

The Influence of Adhesive Luting Systems on Bond Strength and Failure Mode of an Indirect Micro Ceramic Resin-based Composite Veneer

This study evaluated the bond strength and failure mode of enamel/resin-based composite veneers bonded with three different dual cured resin adhesive systems. Standard preparations for laminate veneer restorations were made on 30 human central incisors using depth cutting burs (0.5 mm depth at the incisal area and 0.3 mm at the gingival area). Thirty indirect laminates were prepared using a highly filled polymeric material (GC Gradia) according to the manufacturer's instructions. After sandblasting the fitting surfaces, the specimens were randomly divided into three groups (ten per group) based on the type of resin cement luting systems; Excite/Variolink II, Single Bond/Rely X Veneer Cement, and Clearfil New Bond/Panavia F. The specimens were stored in water at 37 degrees C for 48 hours. Fracture testing was performed using a universal testing machine where the load was applied from the incisal direction at 135 degrees to the long axis of the tooth (0.5 mm/min). The one-way analysis of variance (ANOVA) and Chi-Square tests were used for statistical analysis at a significance level of p > 0.05. The ANOVA showed no significant difference was found among the groups (P > 0.05). Indirect veneers showed mean enamel bond strength of 114.4 +/- 48 N, 159.7 +/- 83.4 N, and 126.1 +/- 51.7 N with Variolink II, Rely X veneer cement, and Panavia F, respectively. The Chi-Square tests showed no significant difference regarding the failure mode frequencies in different types of failure in the three groups (p>0.05). The failure mode analysis showed mainly adhesive failure in the resin cement/laminate interface in all groups. There was no significant difference in bond strength of veneers with the three different resin cements tested. In addition, there was no significant difference in the frequency of the failure mode in each type of failure among the three test groups. The failure analysis revealed mainly an adhesive failure at the resin cement/veneer interface. The results of this study suggest the use of Excite/Variolink, Single Bond/RelyX, or Clearfil New Bond/Panavia F are all appropriate choices for luting of indirect micro ceramic resin-based composite veneers in terms of bond strength and failure mode.

Direct versus Indirect Veneer Restorations for Intrinsic Dental Stains

Direct versus Indirect Veneer Restorations for Intrinsic Dental Stains

Direct versus indirect veneer restorations for intrinsic dental stains.

Patients with discoloured teeth frequently present to the dentist requesting restorations designed to improve their appearance. For teeth that are sound, this might include the use of a veneer restoration. The veneer acts as a thin layer of a material covering the labial surface of a tooth and can be applied directly to the tooth, or by using indirect methods. To examine the effectiveness of direct versus indirect laminate veneer restorations. The following electronic databases were searched: The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library Issue 3, 2002), MEDLINE (1980 to 19/11/2002) and EMBASE (1980 to 19/11/2002). There was no restriction on language. All randomised controlled trials (RCTs) of participants with permanent anterior teeth suitable for restorations using laminate veneers, comparing direct (different composite materials) and indirect techniques for making dental veneers. The indirect restorations may be either composite or porcelain. The primary outcome was restoration failure. Assessment of relevance and validity and data extraction were conducted in triplicate. Authors of the primary studies were contacted to provide additional information as necessary. Six full publications were screened as being potentially relevant to the review, only one trial was found to meet the review's inclusion criteria. Although the trial met the review's inclusion criteria with regard to participant characteristics, interventions and outcomes assessed, problems with the reporting of the data prevented any statistical analysis of the results. There is no reliable evidence to show a benefit of one type of veneer restoration (direct or indirect) over the other with regard to the longevity of the restoration.

Etched porcelain veneer restoration of a primary tooth: A clinical report

The treatment of a retained primary tooth in the adult dentition has always been a difficult clinical problem. In the anterior region of the mouth, the problem is further complicated by esthetic requirements. In this clinical report, a primary canine was recontoured both incisally and interproximally with an etched porcelain veneer to provide an esthetic result. The use of etched porcelain as an indirect veneer material, which has demonstrated clinical success, is an alternative to the requirements of conservative dentistry, namely, preservation of tooth substance and safeguarding primary tooth vitality. The procedure used in this clinical report differs from traditional procedures. The preparation was extended to the lingual surface of the tooth, which allowed for an increase of the incisal length and added a sufficient amount of porcelain. The etching procedure was performed twice by applying 30% phosphoric acid etchant gel to the prepared tooth.

Indirect porcelain veneer technique for restoring intrinsically stained teeth.

Indirect porcelain veneers are often the ideal restoration for intrinsically stained teeth. This article details a step-by-step procedure for esthetically restoring discolored teeth. Porcelain laminate veneers are often indicated when teeth bleaching or direct composite bonding procedures cannot provide the desired esthetic result. Veneers are more appealing to many patients than full coverage crowns because of the more conservative tooth preparation required. If technique details are followed meticulously and cases are appropriately selected, porcelain veneers are not only durable but also promote marvelous gingival health and may be the most esthetic anterior dental restoration.

Restoration of Maxillary Anterior Teeth Using Porcelain Jacket Crowns and Porcelain Veneers

Combining different types of restorations when restoring maxillary anterior teeth poses a difficult esthetic problem. This article describes a method of restoring maxillary anterior teeth using a combination of porcelain jacket crowns and indirect porcelain laminate veneers.