As we know, the demand for esthetically pleasing restorations in clinical dentistry is ever growing with a variety of procedures and material options to choose from. This choice is basically based upon the wants and desires of the patient.
As dentists, we are required to develop the skill sets for providing esthetically pleasing results without compromising the biological and functional principles of natural dentition. The direct composite veneer is among the most minimally invasive treatment modalities available for the rejuvenation and restoration of patient’s smile. It is well suited for esthetic and conservative improvement of anterior teeth by applying tooth-colored material (i.e., composite) to restore localized or generalized defects and intrinsic discolorations or spacing. Common indications for such protocol; include teeth with facial surfaces that are malformed, discolored, abraded, or eroded or have faulty restorations or with multiple interproximal spacing.
For many dentists, using a silicone index as a guide for anterior composite restorations is one of the most significant game changers in dentistry. It’s a wax-up imprint designed for transferring information into the patient’s mouth during treatment. Because the sagittal dimension of the desired result, as well as the mesial and distal angles, the incisal thickness, and the facial curvature of the restoration, are already perfectly defined by the wax-up, the practitioner may fully concentrate on the application of the composite layers as a guided approach.
The case presented below is for a 26-year-old female patient. She had multiple spacing in her maxillary anterior segment and short lateral incisors and canines. The treatment options for such case would be orthodontic treatment (i.e., which is the ideal treatment option), indirect restorative approach, and the direct one. After discussing the treatment options, she chose the direct approach (composite veneer).
To improve the length/width ratio of the teeth and close the diastemas, diagnostic study casts were made, and a wax-up of teeth from canine to canine was created according to a 2D smile design. After that, palatal silicone index was made. The most used material for such purpose is the vinyl polyvinylsiloxane, also referred to as PVS, because of their high reproduction of detail and high final hardness.
So, without further ado, I will leave you the images for the case.
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