Demystifying Smiles: A Case Report

INTRODUCTION

The impact of dento-facial aesthetics on an individual's smile, appearance, self-confidence, psycho-social well-being and overall mental health is an irrefutable fact.¹

Direct placement of composite veneers provide greater control, conservative removal of tooth structure, as well as an easy repair and modification at any stage. These restorations allow the preoperative anatomy of the teeth to be re-established which was lost due to caries invasion.^2,3

Discolorations of teeth or restorations, dental malformations or mal-positions, diastemas, crown fractures and erosive or abrasive defects are some examples of indications of direct composite veneers.⁴

This case report describes smile makeover with direct composite veneers on mandibular incisors with class-4 caries. Three-year clinical follow-up of the restorations is evaluated and the success is discussed.

CASE REPORT

A 18-year-old young female reported in dental OPD. The patient was not satisfied with her smile because of the broken appearance of mandibular anterior teeth (Image A & B). Various treatment options were explained to patient and it was decided to opt for direct composite veneering taking age of patient into consideration. The color was recorded using the VITA Classical shade guide, and shade A2 were matched his tooth color. Rubber dam was not taken into consideration as patient was apprehensive and uncomfortable with it. Minimally invasive preparations rather than full veneer preparations were performed on mandibular incisors. The depth of the preparations was limited in enamel tissue as much as possible. The enamel surface was etched using 37% phosphoric acid (D-Tech Etching Gel) for 15 seconds and rinsed for 10 seconds, and dried. A bonding agent (Futura Bond DC, GC) was applied on the prepared enamel and light-cured for 10 seconds.5 A2 shade composite restorative material (GC Solare Sculpt) was applied on the prepared enamel. The composite was light-cured for 20 seconds on each surface. Increments of enamel shade composite A2 (GC Solare Sculpt & Bond) were placed for rebuilding the enamel and light cured for 20seconds. Finishing and polishing were performed by using finishing diamond bur and Sof-Lex 3M ESPE (Diamond Polishing System).

Post-operative photograph was taken(Image C & D).

DISCUSSION

The importance for esthetics is increasing in the practice of modern world of dentistry. The demand for esthetic motivates the patient to seek dental treatment which is often governed by cultural, ethnic, and individual preferences. The goal of treatment for the case is to restore patient’s esthetics and self-esteem.

Direct and indirect veneers, as esthetic procedures, have become treatment options for patients with esthetic problems of anterior teeth in recent years. In deciding between those two treatment alternatives, the cost, social and time factors have to be considered. Although ceramic laminate veneer restorations have some advantages like color stability and high resistance against abrasion, they have also some drawbacks, including high cost and long chair-side time. Moreover, they have some problems such as necessity of an additional adhesive cement.^6,7

Direct composite veneers are indicated for esthetic make-over in these cases because of conservative tooth preparation and because they can be completed in single appointment, frequency of replacement or repair is less, they are strong and durable, no luting agent is required, and it is economical. In addition, they have similar abrasion rates as that of natural tooth structures.^8,9

CONCLUSION

Composite restorations warrants success and assures optimum performance by a minimally invasive procedure, assuring a long lasting, functional and natural smile makeover in a single visit.

With new composite systems great optical properties and esthetics have been achieved. However, it is ultimately up to the dentist, as an artist, operator, and scientist, to understand the principles of working with composite systems so as to immaculately restore the dentition with its optimum function and esthetics.

REFERENCES