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Case Study
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The Maxillary Anterior Dentition: Direct Resin Restoration

A Case Report

Learning Objectives: 

This study describes a polychromatic color layering technique for the fabrication of resin veneer restorations in the maxilla. Upon reading and completing the piece, the reader should:

  • Comprehend the various criteria that are essential for direct composite restorations.
  • Have a working knowledge of the direct composite method.

 

Patient demand for minimally invasive aesthetic dentistry has resulted in the extensive utilization of freehand bonding of composite resin to anterior teeth. In order to achieve a functionally successful and natural-appearing direct composite restoration, the clinician must have a comprehensive knowledge of adhesive dentistry, including the properties of composite resins, proper tooth preparation techniques, the optical properties of the natural tooth, and the four dimensions of color. The objective of this article is to demonstrate the polychromatic layering of color to fabricate ten direct resin veneer restorations for the maxillary anterior dentition. 

The ongoing development of composite resins has been a useful advancement in the field of aesthetic dentistry. Their advancement allows for the replacement of enamel and dentin with a material that mimics the physical and optical properties of enamel and dentin as effectively as porcelain, but with less invasive preparation. These advances in material and adhesive technology result in improved bond strengths that facilitate the use of direct bonding for the intraoral fabrication of restorations that are clinically indistinguishable from the natural dentition. 

Advances in material technology and adhesive dentistry have enabled the development of freehand bonding techniques that allow the provision of conservative treatment. A composite layering technique combined with proper finishing protocols can achieve harmonious restorations. Clinicians may apply their knowledge of color to select and place composite resin to create bonded resin veneers that closely simulate the optical properties of a natural tooth, thus preserving the direct-bonded resin option as a valuable treatment modality. 

 

*Clinical Assistant Professor, University of Texas Health Science Center, Houston, Texas; private practice, Houston, Texas.

 

Related Reading:

  1. Dietschi D. Free-hand composite resin restorations: A key to anterior aesthetics. Pract Periodont Aesthet Dent 1995;7(7):15-25.
  2. Miller M. Microfills. In: Reality 1998. 12th ed. Houston, TX: Reality Publishing, 290.
  3. Heymann HO. The artistry of conservative esthetic dentistry. J Am Dent Assoc 1987;Special No:14E-23E.
  4. Baratieri LN, Andrada MAC, Montiero S Jr. et al. Dentistics-Procedimentos Preventivos e Restauradores. 2nd. ed. Sao Paulo, Brazil: Quintessence Publishing, 1992.
  5. Clark EB. Tooth color selection. J Am Dent Assoc 1933;20:1065-1073.
  6. Miller A, Long J, Cole J, Staffanou R. Shades selection and laboratory communication. Quint Int 1993;24(5):305-309.
  7. Sproull RC. Color matching in dentistry. I. The three-dimensional nature of color. J Prosthet Dent 1973;29(4):416-424.
  8. Touati B, Miara P, Nathanson D. Esthetic Dentistry & Ceramic Restorations. London, UK: Martin Dunitz, 1999:39-60.
  9. Baratieri LN. Esthetic Principles [in Portuguese]. Sao Paulo, Brazil: Quintessence Publishing, 1998:48.
  10. Fahl N Jr. Predictable aesthetic reconstruction of fractured anterior teeth with composite resins: A case report. Pract Periodont Aesthet Dent 1996;8(1):17-31.
  11. Renamel restorative system clinical brochure. Cosmedent, Inc. 1994.
  12. Miller M. Direct/indirect resin veneers. In: Reality 1998. 12th ed. Houston, TX: Reality Publishing, 625-633.
  13. Nixon RL. Mandibular ceramic veneers: An examination of diverse cases integrating form, function, and aesthetics. Pract Periodont Aesthet Dent 1995;7(1):17-26.
  14. Fahl N Jr. The aesthetic composite anterior single crown restoration. Pract Periodont Aesthet Dent 1997;9(1):59-70.
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