Veneer Restorations Research Articles

Behavior of CAD/CAM ceramic veneers under stress: A 3D holographic study

ObjectivesCeramic veneers restorations may undergo damages, such as cracks, fractures, or debonding. Full-field measurements must be carried out in order to visualize and analyze the strain fields. This paper demonstrates that digital holography permits to investigate the mechanical behavior under stress of a natural incisor and a natural incisor reconstructed with CAD/CAM ceramic veneer. MethodsThe facial surface of a maxillary central incisor is prepared to receive a monolithic ceramic reconstruction manufactured using a chairside computer-aided design and computer aided manufacturing (CAD/CAM) system (Cerec AC® system, Sirona Dental System®, Bensheim, Germany). One incisor is kept intact for comparison. The samples are sectioned longitudinally to obtain a planar observation of the region of interest. A mechanical indentation head and digital holographic set-ups permit a full-field, contact-less and single-shot measurement of the three-dimensional displacement fields at the surface of the tooth sample when subjected to load. Stain fields are then estimated and comparison of the results between two samples can be carried out. Results3D displacement, fields and strain fields are measured and highlight the behavior of the region of interest in three directions of space for the ceramic veneer and the natural incisor. The strain maps reveal the local behavior, especially the concentration or the sudden change in strain. The transition zones are clearly observed, particularly for the veneered sample. ConclusionDigital holography highlights the localization of stress concentration zones in regions of interest and yields comparative analysis between samples with different tooth preparations. Significanceholography permits to visualize and compare the mechanical response of the ceramic veneer and natural tooth. This helps choosing the mechanical properties of the bonding interface.

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.

Marginal and Internal Adaptation of Occlusal Veneer Restorations: Effect of Material Type and Bonded Substrate

Marginal and Internal Adaptation of Occlusal Veneer Restorations: Effect of Material Type and Bonded Substrate

Debonding of Leucite-reinforced Glass-ceramic Veneers Using Er, Cr:YSGG Laser Device: Optimizing Speed with Thermal Safety.

Removing laminate veneers on anterior teeth by using an Er,Cr:YSGG dental laser can be completed faster than previously reported while maintaining thermal safety.

Digital smile design as a tool in the planning of porcelain laminate veneers restoration

ABSTRACT Digital smile design is an important tool for esthetic planning in dentistry as it facilitates ease of communication between professionals and patients. This clinical report has the objective of describing a clinical procedure involving digital smile design for the placement of porcelain laminate veneer restorations. The digital smile design included dental and facial analyzes. The smile curve was drawn and a dental ruler was used to delimitate the spaces between each tooth. An approximate simulation of the smile was generated using Adobe Photoshop software. For esthetic and functional evaluation of the digital plan was created a diagnostic waxing and mock-up. The laminate veneers were made with feldspathic porcelain. Digital smile design was essential for successful planning because it enabled better patient contact with the end result. This case demonstrates the importance of this tool in esthetic dentistry.

A case report of using computer simulation guide for laminated veneer restoration treatment

A case report of using computer simulation guide for laminated veneer restoration treatment

Difference in clinical performance between porcelain laminate veneer restoration and high-flow composite resin coating

Difference in clinical performance between porcelain laminate veneer restoration and high-flow composite resin coating

Influence of Different Preparation Designs on Fracture Resistance of Full-Coverage Occlusal Veneers After Thermo-Mechanical Aging Simulation

Aim: To evaluate the fracture resistance maxillary molars restored with lithium disilicate glass-ceramic (LDG) occlusal veneers with two preparation designs. Subjects and methods: Twenty extracted maxillary molars were assigned to two groups (n = 10). In group 1 (GROUP S ), the teeth received a preparation for a conservative full-coverage occlusal veneer restoration with a 90 rounded shoulder margin. In group 2 (GROUP c), were prepared with a minimally invasive chamfer. LDG restorations (IPS e.max CAD) were obtained with the Cerec 3 CAD/CAM system and luted with Variolink II cement. After thermo-mechanical aging (120,000 cycle with vertical movement 1mm, horizontal movement 3mm and frequency 1.6Hz), All the samples were individually mounted on the Instron testing machine with a load cell of 5 KN and fracture test was done by compressive mode of load applied occlusally using a metallic rod with spherical tip (5.6 mm diameter) at cross-head speed of 1mm/min. The load required to fracture was recorded in Newton and tabulated to be statistically analyzed. The fractured specimens were examined to detect the mode of failure. Results: The fracture resistance of samples with chamfer finish line (2453.2 N ± 104.83) was higher than the values of samples with shoulder finish line (2440.6 N ± 119.36) but with no statistical significant difference (p value > 0.05). Most of the observed specimens exhibited restorable fractures. Conclusion: This study demonstrated similar satisfactory performance of the two considered preparations designs for occlusal veneer with lithium disilicate glass-ceramic. Conclusion: A new minimally invasive occlusal veneer preparation with marginal chamfer exhibited encouraging fracture resistance that were comparable to those of a standard conservative preparation for the restoration of molars with CAD/CAM lithium disilicate occlusal veneers.

Microscopic veneer restorations of anterior teeth guided by three-dimensional printing guide plate: a case report

对1例美学修复病例使用数字化美学设计指导美学蜡型制作，通过美学蜡型与研究模型的数据拟合，设计牙体预备导板并进行三维打印，配合显微牙体预备等技术进行上前牙微创修复，术后及术后1年效果良好，改善了患者的前牙美观，获得满意的修复效果。.

Survival Rates for Porcelain Laminate Veneers: A Systematic Review.

The aim of this systematic review was to analyze and compare the most up-to-date information available on long-term, medium-term, and short-term survival rates of porcelain laminate veneers (PLVs) and investigate the homogeneity in current studies or lack of it. An electronic search was performed using PubMed, Ovid MEDLINE, Cochrane Library, Web of Science, EBSCO, Science Direct, Wiley, and Scopus databases. Based on the PRISMA guidelines, the main inclusion criteria consisted of research articles published after the year 2000, in vivo studies with a follow-up period of at least 1 year and reporting of the Kaplan–Meier estimated cumulative survival rates. Quality assessment of the included studies was performed using the modified systematic assessment list consisting of 24 items. Thirty full-text articles were reviewed in detail. A total of 30 articles met the inclusion criteria and were selected for qualitative synthesis. The remaining 27 publications were retained to discuss the heterogeneity in the current literature and reported longevity of veneer restorations. A conclusive estimation of the longevity of PLVS beyond 20 years is lacking. The availability of evidence in the current literature is limited in terms of sample size and duration of follow-up. However, the majority of studies have concluded that PLVs have high-success rates and predictable patient outcomes. The present literature indicates an increased heterogeneity among research study designs. Researchers should aim for homogeneous study designs that can be included in systematic reviews and meta-analyses.

Finite Element Analysis of Occlusal Veneer Restorations: Effect of Material Type and Bonded Substrate

Finite Element Analysis of Occlusal Veneer Restorations: Effect of Material Type and Bonded Substrate

A customized metal guide for controllable modification of anterior teeth contour prior to minimally invasive preparation

ObjectiveOptimal tooth reduction is a key requirement for aesthetics, function, and the longevity of fixed restorations. Research has demonstrated that controlled and conservative tooth preparation is crucial for the long-term success of adhesive restorations. Different techniques of fabricating reduction guides have been previously reported in literature. The present technical note describes the fabrication technique and clinical application of a customized metal preparation reduction guide. Material and methodPatient presented with tilted maxillary left central incisor. The flared-out part of the tooth was modified prior to veneer restoration preparation. Resin pattern reduction guide was fabricated on the diagnostic cast with a window on the tilted mesial portion of the tooth. After intraoral evaluation, resin pattern guide was casted. Metal reduction guide was place intraorally and reduction was provided on the exposed surface of the tooth. After the removal of the tilted portion, a harmonious arch form allowed the clinician to provide adequate evaluation and preparation for veneer restorations. ResultsThe device demonstrated good practical value, allowing for selective and controlled reduction of tooth structure, and definitive protection of adjacent tooth surfaces from iatrogenic damage. The clinical outcome successfully addressed the patient’s restorative and aesthetic needs, and the veneer was stable 2 years postoperatively. ConclusionUse of a metal guide assists clinicians to provide a more predictable reduction of a desired tooth surface, while decreasing the risk of compromising the other/adjacent tooth surfaces.

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.

Management Of White Spot And Central Diastema On Anterior Teeth With Direct Composites Restoration (A Case Report)

Background: One of the most common aesthetic problems is discoloration and central diastema of the anterior teeth. This can make the patient's appearance disturbed and can lead to confidence in influential patients in the complex interaction of social, cultural and psychological disorders. Purpose: The purpose of this case report is to explain the management of white spot on central incisive with central diastema. Case: A 22 years old woman came to Airlangga Dental Hospital with a chief complaint of shyness and lack of confidence due to some white spot and gap on the two central front teeth. Management: The treatment of white spot and central diastema were done using a partial direct veneer technique. Conclusion: White spot and central diastema treated with partial direct veneer restoration is able to produce good aesthetic results.

Operational specifications for the cementation of porcelain laminate veneers

The minimal tooth reduction, esthetic appeal and biocompatibility of porcelain laminate veneers have made them one of the mainstream technologies for minimal invasive esthetic dental restorations. Cementation is a crucial step in ensuring retention, marginal seal and influencing the clinical longevity of veneer restorations. Experts from Society of Prosthodontics, Chinese Stomatological Association formulated operational specifications for the cementation of porcelain laminate veneers, so as to standardize the clinical operating procedures, achieve the long-term success of veneer restorations, and promote the application of porcelain laminate veneers.

Masking Tetracycline Stained Teeth: Effect of Translucency and Thickness of Multiple CAD-CAM Masking Tetracycline Stained Teeth: Effect of Translucency and Thickness of Multiple CAD-CAM Veneer Materials and Shades of Resin Cements

Abstract This study aimed to assess the masking potential of different CAD-CAM veneer restorations to restore tetracycline-stained teeth. One-hundred-eight CAD-CAM ceramic discs, shade 1M1, with high (HT) and low (LT) translucencies and 1mm and 0.7mm thicknesses were prepared from three CAD-CAM materials (IPS-e.max-CAD (EMC), VITA Enamic (VE) and Vita Suprinity (VS)). Resin cements, shades A1, white opaque (WO) and translucent (T), were used for cementation against a dark base. Color differences (ΔE*) between the restorations (veneer/resin cement/dark base) and a standard 1M1 shade-guide-tab were calculated. Mann-Whitney-U and Wilcoxon-signed-rank tests; and one-way ANOVA, Kruskal-Wallis and Bonferroni-post-hoc tests were used to compare between two and three groups respectively (P ≤0.05). Groups EMC-LT-0.7-T, VE-LT-1-A1 and VE-LT-1-T rendered restorations with ΔE* below the perceptibility threshold (<1.74), while EMC-LT-0.7-A1 and all LT-0.7mm VE restorations were within the acceptability threshold (<3.48). VS had significantly higher (ΔE*) compared to of EMC and VE materials. Ceramic thicknesses had no significant effect on (ΔE*), while the effect of translucency level of the ceramics and the shade of resin cement was significant. It was concluded that low translucency ceramic veneers can better mask darkly stained teeth, irrespective of their thicknesses, with resin cements shades affecting the color of the final restorations.

Assessment of Fracture Force of CAD-CAM-fabricated Occlusal Veneer Restorations with Different Thicknesses

Assessment of Fracture Force of CAD-CAM-fabricated Occlusal Veneer Restorations with Different Thicknesses

The utilization of snap-on provisionals for dental veneers: From an analog to a digital approach.

There are multiple treatment options to enhance a patient's smile, from conservative bleaching procedures to composite resins, porcelain veneers, or full-coverage crowns. Treating patients with porcelain veneers is a commonly used approach in esthetic dentistry. Provisional restorations for veneers can be time-consuming to make and difficult to retain. This article illustrates a technique for fabricating indirect snap-on provisional restorations for veneer cases, describing both analog and digital approaches. The present article presents an alternative provisionalization technique using snap-on restorations for dental veneers. Application of these techniques will allow for ease of cleansability by the patient leading to healthier soft tissues before the final cementation. Delivery of veneers is more predictable with healthy soft tissue, as bleeding and inflammation may affect the bonding process. This technique is an effective provisionalization option in most veneer cases. This approach seems to be well accepted by patients and a good alternative in helping to maintain optimal gingival health with interim restorations before delivery. The use of snap-on provisionals for veneer restorations will allow the clinician to have an efficient technique with better tissue response before cementation. This prevents inflammation and facilitates a controlled delivery process.

Effect of light intensity, light-curing unit exposure time, and porcelain thickness of ips e.max press and vintage LD press on the hardness of resin cement

Background: Porcelain veneer restoration is the primary choice for indirect restoration, especially for anterior teeth, given its high esthetic properties and lower failure rate than resin composites. Glass-based ceramics such as IPS e.max Press and Vintage LD Press are a choice for veneer due to its superior physical properties. Resin cement is used to attach the veneer restoration to the teeth. The polymerization of resin cement used in veneer restoration affects the stability, mechanical properties, and resistance of the restoration. The composition and thickness of the porcelain material affect the light-curing unit to cured resin cement. Objectives: The aim of this study was to evaluate the influence of porcelain thickness, light intensity, and exposure time in the hardness of resin cement. Methods: Porcelain samples measuring 5 mm in diameter with three types of thicknesses of IPS e.max Press and Vintage LD Press were used in the study. Resin cement in a metal mold was placed under a porcelain sample before curing with a light-emitting diode (LED) intensity of 1300 or 1700 mW/cm2. The hardness test was then carried out on the bottom of the resin cement. Result: The highest hardness value was obtained from a Vintage LD Press with a thickness of 0.7 mm (cured at 1300 mW/cm2 for 20 s). A four-way ANOVA test showed significant differences for brands, thicknesses, and times of exposure (P

Conservative Ultrathin Veneer Restorations with Minimal Reduction: A 5-year Follow-up Report

This case report shows how a feldspathic veneer with diagnostic wax-ups, subsequent mock-up, and reduction guides can lead to good patient esthetics and reports a 5-year follow-up. Conservative tooth preparation is important for the long-term success of adhesive dentistry as it has been shown that bonding to enamel is more predictable in obtaining better long-term success than dentin. To preserve enamel for optimal bonding, diagnostic wax-ups and the subsequent mock-up are the first tools in a restorative dentist's arsenal to find and address differences between current and ideal tooth proportions and also help toward an overall conservative approach. Reduction guides are recommended in order to provide adequate tooth reduction and prevent over-reduction. This case report shows a 5-year follow-up of feldspathic veneer restorations for a patient with excessive space among teeth, defective composite restorations on facial and incisal surfaces, and worn teeth. Veneers were delivered with conservative tooth preparation combining different tooth reduction guides. This case report highlights the added benefits of tooth reduction guides and diagnostic wax-ups and the subsequent mock-up for long-term patient satisfaction. Conservative tooth preparation, reduction guides, and wax-ups may increase the life span of veneer restorations and demonstrate good esthetics at 5 years.