Dentaltown March 2020 - 74

Case Study 1: Same-day smile makeover with 13 direct composite
veneers to correct chips, stains, spaces and wear

I've been able to do beautiful direct
composite veneers at a pace of about 30 minutes each, which has improved my chair
time by 50%. Now, high-quality direct
composite veneers can be done efficiently,
and no longer are a treatment option that
has only a few applications.

The patient presented with multiple diastemas, chips, staining and wear on her
upper and lower anterior teeth (Figs. 7a-c). A highly educated counseling professional
from Egypt, she had been promoted to chief counselor for her school district, where
she intervenes with family and student crises at all campuses. She knew that first
impressions are important and believed that her smile made her look "uneducated,"
which affected her confidence and effectiveness in meetings. While researching
cosmetic dental procedures, she had discovered that most treatments were damaging
to tooth structure, or less permanent, and when she searched "gapped teeth" the
Bioclear procedure popped up among the results. She traveled two hours to our office
for treatment and was pleased with not only her smile but also the underlying fact
that no tooth structure was removed in her smile makeover (Figs. 8a-c).

Critique and conclusion
This procedure does not result in perfect
outcomes cosmetically. Certainly, it can
be criticized because it does not hold up
to cosmetic dentistry's standard practice
of layering of incisal and body-type color
to mimic natural effects. Those type of
enhancements can be done through cut-back
procedures after warm-injection molding,
if a practitioner prefers; I choose not to
do that because I believe it weakens the
monolithic strength of the restoration, and
the patients are perfectly happy with the
appearance. Those "layered effects" are
not seen at social distances, anyway. If a
patient prefers such effects in their teeth,
I do suggest porcelain veneers.
Direct composite veneers should be
an addition to most dentists' repertoire of
services for restorative and cosmetic treatments, because with the proper materials
and methods they're easier, more predictable
and more profitable than ever before. If
dentists combine these tools and methods,
they can provide quality direct composite
veneers in an efficient and profitable manner
in their office while saving their patients
money and priceless tooth structure.
With this method and these materials,
numerous cosmetic issues can be treated:
diastemas, peg laterals, worn anterior teeth,
dark triangles, stained teeth, dark teeth,
short teeth, chips, misproportioned teeth,
uneven incisal plane or edges, establishing
anterior guidance. This all can be done in
one visit, and with minimal to no tooth
structure removal. ■

74

Fig. 10: Test "veneer" removed, showing
how thin it can be.

Figs. 7a-c

Fig. 11: Uveneer test fit under Bioclear matrices
for width and length.

Fig. 12: Appearance of smooth facial after
removal and trimming of incisal edges.

Figs. 8a-c

Fig. 9: Uveneer used to test veneer for
shade and get patient's approval.

Figs. 13a, 13b: Notice marginal integrity of
diastemas and dark triangles closed, which the
Bioclear matrices and warm-injection molding
make possible.

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Dentaltown March 2020

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