Restorative treatment of discolored anterior teeth III

The composite veneer Definition: The dental veneer is a thin layer of composite material or dental procaine bonded to the surface of tooth

Indication

Improve extreme discoloration such as tetracycline stain ,fluorosis ,devitalized and teeth darkened from age .

Repair Chipping or fracucture of teeth

Closing of diastemas between teeth

Ability to lengthen anterior teeth

Improve the appearance of rotated or misaligned teeth

Agenesis of the lateral incisor

Poor restorations

contraindication

Certain tooth to tooth habits like bruxisim or clenching or other para-functional habits .

Severe crowding .

Certain types of occlusal problems such as class III&edge to edge bite

Poor oral hygiene & high caries rate

types of composite veneer: 1- according to the design: Partial veneer Full veneer Laminate veneer 2- according to the methods: Partial veneer: Direct -----------chair side composite resin. Full veneer: Indirect----- ----indirect composite resin, conventional porcelain

Intra enamel preparation before placing a veneer is strongly recommended for the following reasons: 1- to provide space for opaque, bonding or veneering materials for maximal esthetics without over contouring. 2- to remove the outer ,fluoride-rich layer of enamel that may be more resistant to acid –etching. 3-to create a rough surface for improved bonding 4- to establish a definite finish line.

Partial veneers Are indicated for the restoration of localized defects or areas of intrinsic discoloration Direct composite veneer Extensive enamel hypoplasia involving all of the maxillary anterior teeth was treated by direct composite veneers. A diastema also exists between the central incisors. the patient desired to have both the hypoplasia and diastema corrected; examination indicated a good prognosis. A direct technique was used with a light- cured . micro fill composite .

Advantages of composite veneers one visit procedure less expensive repair potential chair-side control of the anatomy minimal irreversible loss of tooth structure

Disadvantages of composite veneers tend to discolor wear out quickly marginal staining shade matching difficulty often require repair and replacement

Technique for direct partial composite veneer Case presentation:

Full veneer are indicated for restorastion of generalized defects or area of intrinsic staining involving most of the facial surface of the teeth Indirect full veneer : Indirect veneer require two appointment , but typically offer three advantages over direct placed full veneer:

1-Indirectly fabricated veneer are much less sensitive to operator technique. Indirect veneer are made by a laboratory technician and are typically more esthetic. 2-If multiple teeth are to be veneered, indirect veneers usually can be placed much more expeditiously . 3-Indirect veneer typically will last much longer than direct veneers. Especially if they are made of porcaine or pressed ceramic.

1-Indirect composite veneer Composite veneer can be processed in laboratory to achieve superior properties

Technique: First appointment: Window preparation recommended due to limited bond strength. Incisal lapping if incisal defect. Interaenamel preparation. Elastomeric impressions. No temporization .

Second appointment: Evaluate fit of veneer. Tooth side of veneer (pre etched) is primer. Tooth etched, rinsed and dried . Adhesive is applied but not cured . Adhesive cement applied. Veneer placed and excess cement removed . Light cured for 40-60 sec facial &lingual. Check for fit with no. 2 explorer.

2- conventional porcelaine veneer Conventional porcelain veneer is a thin piece of porcelain that is bonded to the front of a tooth. Porcelain is a durable, translucent, Strong. Natural-looking, and beautiful material . The only difference in this procedure for porcelain veneers from the composite veneer is the need to condition the internal surface of each veneer with a silane primer just befor applying the resin-bond agent

Advantages: 1- very conservative. 2-offer better inherent color and natural. 3-tissue tolerance is excellent. 4-less staining. 5-the bond of etched porcelain veneer to enamel is stronger than other. 6-wear and abrasion are better resistance is high. 7- the aesthetic are better than any other veneer material . 8- porcelain veneer allow transmission of light.

Disadvantage: 1- expensive. 2- tooth preparation. 3- highly sensitive technique. 4- sensitivity. 5- limitation.

Technique:

First appointment (VENEER PREPARATION PROCEDURE) Shade selection clean teeth with pumice and water select a tentative shade with your patient participation Tooth preparation A uniform 0.5mm intraenamel reduction is sufficient Preparation are extended to the gingival crest and into the interproximal without breaking contact

Impression

Temporary veneer

Second appointment (VENEER CEMENTATION PROCEDURE) Remove temporary – clinical try in Remove temporary – crown try in

Cementation

Full coverage restorations The covering layer of porcelain is thicker. Full coverage also place less reliance on bonding as means of retention . Although there are usually more aesthetic alternative for anterior teeth , zirconia crown are useful in the treatment of tetracycline teeth , especially if the preparation has a deep enough chamfer to allow a sufficiently thick veneering layer of esthetic porcelain . The need to use porcelain fused to metal (PMF) crowns would appear to be limited except in the most extreme cases where great strength is an advantage , for example when parafunctional habits, such as bruxisim , are combined with deep tooth discoloration

THANK YOU DONE BY: Farah al duiji 5365 Alaa alrashed 5743 Thikra arafa 5732 Lujain bajsair 5093 Ibtehal anas 5486 Shrooq zaloom 5647