Variations Of Porcelain Veneer Usage, Case 2
by Dr. Greg Janikian, D.D.S.
Unfortunately, in adolescence, traumatic fracture of the upper anterior teeth is common. Consequently, some of these must be treated endodontically. Darkening of the affected tooth can occur compounding the restorative problem with a cosmetic one. Porcelain veneers with opaque material on the internal surface can restore form, function and color. More conservative than a crown, a veneer can restore a mesio/disto angular fracture and strengthen an endodontically treated tooth.
A sixteen year old white female presented with a chief complaint of "darkening" of her upper central incisor. The tooth had suffer traumatic fracture some 8 years ago. Subsequently, endodontic therapy was performed and the tooth was restored with composite bonding. The other central incisor had fractured and been bonded but did not require endodontic therapy. (Image 21.)
It was decided that both centrals would be treated with veneers. Without anesthesia both centrals were prepared using diamond burs. Approximately .5mm of enamel was removed from the facial surface of both teeth. The incisal edges were reduced 2mm's and the finish line continued on the lingual surface. The patient had a slight diastema on the mesial but distal contact was not broken during preparation. An impression was taken and shade selected. The teeth were not provisionalized. Note: a deeper reduction at the gingival margin of the endodontically treated tooth was needed, to provide for adequate thickness of the veneer. (Image 22.)
The laboratory technician was instructed to place opaque on the internal surface of the veneer. The opaque blocks out any darkness form the endodontically treated tooth, and a more vital look can be achieved. Placement of the veneers was accomplished using a light activated composite bonding system. Some incisal blending was need to soften line angles and create a more esthetic smile line. (Image 23 and 24.)
|Image 23||Image 24|
There are times when we must sacrifice cosmetic ideals such as translucency for the end result. The use of opaque and or opacious porcelain can block out undesired darkness and elevate the total brightness of a smile.