Severe tetracycline dental discoloration: Restoration with conventional feldspathic ceramic veneers. A clinical report

Abstract

The treatment of severe tetracycline discoloration is a challenge for the dentist. There are several treatment options and one of the most effective is the use of feldspathic veneers. The aim of this clinical case was to carry out the replacement with conventional feldspathic ceramic veneers on a patient with highly stained teeth (grade IV tetracycline) by a minimally invasive approach. Clinical examination revealed gingival retraction, color change of the veneers, ceramic cracked of 1.1 and 1.3 and incisal wear in lower anterior teeth. The decision was to retreat with feldspathic ceramic veneers from 1.6 to 2.6. Premolars and first molars were included because its dark color intensifies the width buccal corridors. Also, the restoration with veneers from 3.3 to 4.3 was considered. Firstly, the veneers were removed and the color was selected by the Vitapan 3D Master guide (Vita Zahnfabrick, Bad Säckingen, Germany). Mock-up was made to evaluate aesthetic, phonetic and functional parameters. Then, teeth were prepared through the mock-up in order to reduce the minimal amount of dental tissue possible. Opaque dentine mass of microhybrid composite (Esthet-X A2O, Dentsply Sirona, Konstanz, Germany) was placed to mask the most intense stains. The definitive impressions were taken with silicone (Aquasil Ultra XLV, Dentsply Sirona, Konstanz, Germany) were taken to fabricate conventional feldsphatic ceramic veneers (Noritake kisai Co, Ltd. Japan) by the parallel stratification masking technique. For cementing, an opaque cement was selected from the try-in tests (Calibra, Dentsply Sirona, Konstanz, Germany) and the composite was silicatized with an air-abrasion device. A favorable and minimally invasive result was achieved to treat grade IV tetracycline stains, surpassing the patient’s aesthetic expectations and functional needs. Key words:Porcelain veneer, tetracycline teeth, minimally invasive, masking, opaque composite.

Impact of Bleaching before or after Veneer Preparation on Color Masking Ability of Laminate Veneers: An In Vitro Study

“…In the BAP group, 0.5 mm thick ceramic veneer (S1) resulted in a Δ E value not statistically significantly different than those obtained for 1 mm thick ceramic veneer (S2) of the three tested groups (NB, BBP, and BAP), which is in agreement with previous studies [ 13 , 29 ], as when the lightness of the substrate shade is increased, a higher Δ E value can be achieved from a thinner ceramic veneer combination.…”

“…In attempting to treat severely discolored teeth by veneering, there is a considerable risk that the dark shade of the tooth tissue substrate will shine through relatively thin and translucent ceramics. Therefore, several approaches have been used to mask the underlying color; these include employing more opaque ceramics and luting cement [ 8 – 10 ], increasing the preparation depth [ 11 ] to allow adequate space for the ceramic thickness [ 12 ], or manipulation of the prepared tooth to lighten its shade [ 13 ]. Each of these approaches has its problems.…”

Three-dimensional analysis of the relationship between the structure of maxillary central incisor and the preparation of dental all-ceramic

“…The results showed that porcelain veneer was 28.35 ± 4.37% and all-ceramic crown was 56.93 ± 3.47%. The reduction in all-ceramic crown was significantly higher than that of the porcelain veneer (P < .05) which was a popular mean of correcting aesthetic because of the conservative amount of tooth structure that needs to be removed [16, 17]. Pearson correlation analysis suggested that there was no correlation between the two types of restoration (P> .05).…”

Uso De Laminados Cerâmicos Em Paciente Com Manchamento Por Tetraciclina: Relato De Caso

“…Diante disso, o uso de laminados cerâmicos, se constitui em uma importante opção. 12,13 Os laminados cerâmicos propiciam mínimo desgaste do dente, o que estabelece melhor estética, tornando-se uma boa opção para dentes manchados por tetraciclina e com uma má resposta ao branqueamento. Esses elementos dentários devem ser incialmente submetidos a um clareamento, a fim de diminuir as manchas, pois os laminados possuem pequena espessura.…”

“…A literatura aponta uma longevidade de 95,7% após 5 anos e 87% após 8 anos para esses materiais. 5,12,14 Tona-se necessário a habilidade do cirurgião-dentista no preparo dos dentes para recebimento de laminados cerâmicos, pois há exigência de treinamento prévio, assim como os procedimentos adesivos para cimentação são críticos e demorados.…”