Direct resin composites have become a popular choice for smile makeovers due to their minimally invasive nature and natural-looking results. These restorations not only save tooth structure but also provide long-lasting and aesthetically pleasing outcomes. However, in the past, clinicians have faced challenges with technique sensitivity and aesthetic predictability when using direct composites. As a result, they often turned to indirect approaches such as porcelain veneers.
Fortunately, advancements in resin composite materials and adhesive techniques have addressed these challenges. Direct composite veneers have emerged as a functional and highly aesthetic option that mimics natural dental tissues in the anterior region. They offer a chairside solution that is not only cost-effective but also preserves natural tooth structure. These veneers are particularly useful for correcting defects in the anterior arch, such as enamel defects, fractures, diastema closure, and improvements in tooth size, shape, color, length, and alignment.
In a recent case, a 32-year-old male patient presented to a dental practice with concerns about the shape and lack of tooth display when smiling. He desired a bright new smile for his upcoming wedding and wanted to regain his self-confidence. The patient emphasized the importance of preserving natural tooth structure and staying within his limited budget.
Upon examination, wear and chipping were observed on teeth Nos. 7 to 10, and a diastema of 4mm was present between teeth Nos. 8 and 9. The treatment plan involved using direct composite veneers on teeth Nos. 4 to 13. However, prior to the restorative treatment, it was necessary to address the intrusive interference causing wear and chipping. Clear aligner therapy was prescribed to correct the anterior relationship, close the diastema, and intrude the lower anterior teeth.
After 15 weeks of aligner therapy, the patient’s anterior relationship was corrected, and the diastema was reduced to 0.5mm. The goal of the final restorative treatment was to achieve golden proportions by lengthening the central incisors, creating a step from the centrals to the laterals, and permanently closing the diastema.
The treatment process involved taking intraoral scans and photos to create a diagnostic wax-up for ideal tooth contour, shape, and occlusion. A silicone putty matrix was fabricated to guide the application of direct composite veneers. The patient was anesthetized, and the correct tooth shade was selected using glycerine to ensure accurate color matching. The teeth were prepared by air abrasion, etching, and bonding.
Layering techniques were used to establish the shape, contour, and aesthetics of the central incisors, which served as a guide for the rest of the teeth. Tint shades and chromatic enamel shades were applied to create a natural appearance with dimension. The veneered teeth were shaped, and secondary and tertiary anatomies were added. Final polishing was performed to achieve a smooth and polished finish.
The outcome of the treatment was checked for occlusion and excursions, and the patient was pleased with the final result. Through the use of direct composite veneers, the patient achieved the desired smile makeover while preserving natural tooth structure and staying within his financial constraints.