Cosmetic dentistry

Cosmetic dentistry includes a variety of dental

treatments aimed at

improving the appearance of the teeth.

The purpose of cosmetic dentistry is to improve

the appearance of the

teeth using bleaching, bonding, veneers,

reshaping, orthodontics, or implants.

Indication1. Discoloration 2. Trauma

3. Anomalies 4. Abnormal spacing

Types of cosmetic dentistry :

A- Generally:

1. Prosthodontic 2. Periodontics

3. Orthodontic

B- In operative:

1. Bleaching

2. Veneer 3. Lumineer

Repairing procedures in operative:Dental veneerdental veneers are custom shells made from tooth colored

materials that facilitate covering the front surface of

the tooth and these are alternately known as dental

laminates. dental veneers are normally classified Under

cosmetic dentistry

Indications:

1. Improve extreme discolorations such as

tetracycline staining, fluorosis, devitalized teeth, and

teeth darkened from age.

2. Repair chipped or fractured teeth.

3. Closing of diastemas between teeth.

4. Ability to

lengthen

anterior teeth.

5. Improve the appearance of rotated or

misaligned teeth.

6. Agenesis of the lateral incisor.

7. Poor restorations.

Contraindication:1. If little or no enamel is present, full crown should be considered.

2. Certain tooth-to-tooth habits like bruxing or clenching, or other

para-functional habits such as pencil chewing or ice crushing.

3. Teeth that exhibit severe crowding.

4. Certain types of occlusal problems such as

Class III & end-to-end bites.

5. Poor oral hygiene.

6. High caries rate.

ARTISTIC ELEMENTS:Shape or form:Masculine smile

More closed and prominent incisal

angles.

Feminine smile

Rounded incisal angles, open incisal and

facial embrasures and softened facial line

angles.

Prominent areas highlighted by light.

Depressed areas shadowed.

Position and alignment

Surface texture:

YOUNG TEETH AND OLD TEETH ANATOMICAL FEATURES

Color:

Cervical areas darker than incisal areas

Young patients-lighter teeth

Older- incisal edge enamel thinned due to wear and is darker

Translucency .

Clinical Considerations:

Esthetics and function

Anterior guidance and occlusal harmony

Physiologic contours

Emergence Profile

Types of veneers:1. According to the design:

-Partial veneer.

-Full 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.

Two basic preparation designs exist for

full veneers :1. a window preparation

2. an incisal, lapping preparation.

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 the 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 veneersare indicated for the restoration of generalized defects or areas of intrinsic staining involving

most of the facial surface of the tooth.

indirect full veneer:

Indirect veneers require two appointment ,but typically offer three advantages over directly placed

full veneer:

1_Indirectly fabricated veneers are much less sensitive to operator technique. Indirect veneers 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 veneers typically will last much longer than direct veneers,

especially if they are made of porcelain or pressed ceramic.

1. indirect composite veneer:

Composite veneers 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.

*Intraenamel preparation.

*Elastomeric impressions.

*No temporization.

Second AppointmentEvaluate fit of veneer.*

*Tooth side of veneer (pre etched) is primed.

*Tooth etched, rinsed and dried. Adhesive is applied but not cured.

*Adhesive cement applied.

*Veneer placed and excess cement removed.

Light cured for 40-60sec facial & lingual.*

* Check for fit with no.2 explorer.

2. Conventional Porcelain Veneers:

A 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 veneers is the need to condition the

internal surface of each veneer with a silane primer just

before applying the resin-bonding agent

Advantages:1- Very conservative.

2- Offer better inherent color and natural look.

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 resistance is high.

7- The aesthetics 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- It has number of limitation .

TechniqueCase presentation:

First Appointment (VENEER PREPARATION

PROCEDURE)

Shade Selection-

Clean teeth with pumice and water

Select a tentative shade with your patient participating.

Tooth preparation-

A uniform 0.5mm intraenamel reduction is sufficient

Preparations are extended to the gingival crest and into the interproximal

without breaking contact

Impression-

Temporary Veneers-

Second Appointment (VENEER

CEMENTATION PROCEDURE)

Remove temporary- Clinical try-in-

CEMENTATION