Esthetic Anterior Veneers
Restoring teeth in the anterior region routinely presents with esthetic challenges. The patient, a 42-year-old female, was unhappy with her smile. Severe decalcification was covered by composite restorations years earlier that discolored over time. The patient's high lip line and significant gingival display presented a challenge that mandated meticulous planning. The spacing and position of the teeth were otherwise ideal, allowing minimal preparation for 6 porcelain veneers.
An increased length of the central incisors would result in more harmonious proportions, so gingival recontouring was recommended. An Odyssey Diode Laser (Ivoclar Vivadent) removed the gingival excess. Proper, consistent, and adequate reduction was facilitated through depth cuts on the facial surfaces of the anterior teeth.
Preparation of the teeth on the centric stops was avoided by checking the occlusion before initiating the preps. Expasyl gingival retraction paste (Kerr) gave adequate retraction and hemostasis for optimal impression conditions. B4 preimpression surface optimizer (DENTSPLY Caulk) provided ideal wetness of the preparations for consistent coating with VPS impression material. An impression material with extended working time, Aquasil Ultra Xtra (DENTSPLY Caulk), was used because several teeth were prepared in this case. Empress Esthetic porcelain veneers (Ivoclar Vivadent) were fabricated by Mike Archibald (Archibald and Associates Laboratory).
The veneers were cemented with the base portion, without catalyst, of Calibra (DENTSPLY Caulk) total etch resin cement, giving extended working time during seating.
Each restoration was placed, margins cleaned, and teeth flossed before an initial tack cure. Excess cement was removed and a full cure with SmartLite (DENTSPLY Caulk) was initiated. The central incisors were seated first, followed by the right and left sides and a final cure of 40 seconds on each restoration was accomplished (20 buccal; 20 lingual).
The 6-month recall showed excellent gingival health and good esthetics. As demonstrated, proper planning of preparation style, material selection, and patient communication is key to the success of every anterior restorative case.