Enhancing Nature to Achieve Patients’ Desires A Smile Makeover Utilizing Componeers.

Author : Dr Rabiya A Hameed

The challenge to copy nature and at the same time to maintain oral harmony is a complex theme in the field of cosmetic dentistry. Aesthetic veneering of anterior teeth is a well-established technique, which was brought to Dentistry by Dr Pincus as early as 1937. Various techniques has emerged such as direct composite restorations, prefabricated composite veneers and individualized porcelain indirect veneers from the concept of composites and adhesive techniques. Composite veneers have recently revitalized taking advantage of new technologies that enables the veneers to exhibit a hard and glossy surface, with a texture to fit the majority of dentitions. Composite veneers are aimed to facilitate the esthetic restoration of decayed/fractured or discoloured single and multiple anterior teeth.

Introduction
Today’s aesthetically driven dental clients can be very exacting with regard to the results they expect from their cosmetic dentist. Advances in cosmetic dentistry techniques and materials available have provided clinicians with the armamentarium to meet virtually any reasonable request with incredible accuracy. Excellent planning and precise execution of the plan yields excellent results. Componeers^R are the propitious and enduring aesthetic enhancement a dentist can offer a patient during time constraint. When implemented accurately, componeersR can often be mistaken for “perfect” natural teeth and smile.

Case presentation

Case 1

Case 2

Discussion
The concept of prefabricated composites veneers was introduced in dentistry long ago, but with limited success due to technological limitations during those times. Because of which, this unique and remarkable treatment option was principally replaced by the porcelain veneering technique and complete crowns. But in last few years this technique revisited by taking advantage of modern technology (Componeer^R). However, this rejuvenated technique does not replace conventional “custom-made” ceramic veneers, rather offers the clinician a single-visit, cost-effective alternative to directly (or free hand) build-up composite veneers. This system allows us to fill in gaps within our treatment modalities with obvious and interesting application potential, such as the treatment of young patients with localized or generalized hypoplasia/dysplasia, discoloration, fractured or maligned teeth and malformed teeth where the long-term aesthetic solution is needed. (Table 1)

Table 1: The whole spectrum of aesthetic procedures embraces four different types of treatments (Dietschi, Devigus, 2011)

Treatment approach	Usual procedures
Non-invasive	Bleaching, microabrasion, orthodontics
Minimally-invasive	Direct composites, enamel recontouring
Micro-invasive	Veneers, inlays and onlays
Macro-invasive	Crowns and bridges

Fixing fractured maxillary anterior tooth in just a single session is one of the most critical aesthetic problems encountered by the clinician leading towards improvising the smile of their patients. Composite laminate, porcelain veneers and metal or all ceramic crown are all options in this case. The patient refused the conventional crown and porcelain veneers because of high cost and long duration of treatment. Componeer^R was the treatment option which was chosen for the following reasons: it provided the patient with beautiful, natural results and without more aggressive preparation required for the porcelain veneers and conventional crown. This modern material (Componeer^R) permitted the clinician to replicate nature perfectly in no time. Also the restoration may be evaluated as reversible treatment procedure, can be corrected as per patient desire intra orally with amazing result. To my experience if these composite veneers are used with right technique with precision polishing there will be no noticeable discoloration in years and if at all it happens it can be reversed. Clinicians have total control on the aesthetic outcome, and lets easy postoperative adjustments and changes’, ensuring absolute patient satisfaction. The entire smile makeover can be completed in a single visit.

The benefits of using Componeer^R are:

• Attractive teeth and a new smile in single visit
• Minimal removal of healthy tooth structure
• Individual, customized contouring of the front teeth
• High quality permanent veneering material used
• Gloss can be reinforced by polishing at any time
• Unlike porcelain veneers, they can be easily repaired

Comprehensive clinical protocol and treatment sequence: (table 2)

Basic protocol of treatment planning remains the same as for other functional and aesthetic treatments. Treatment approach followed as depicted in flow chart below.

Summary
Veneer restorations provide an excellent restorative alternative to less conservative options when confronted with an esthetic problem in anterior teeth. They offer a predictable and successful treatment that preserves a maximum amount of sound tooth structure. The keys for success when using porcelain veneers are an accurate analysis of the patient’s existing occlusion, proper treatment planning, following accepted guidelines, and exercising careful clinical judgment

References

1. Pincus CL “Building mouth personality”. A paper presented at: California State Dental Association, 1937: San Jose, California.
2. Dietschi D, Devigus A (2011) Prefabricated composite veneers: historical perspectives, indications and clinical application. Eur J Esthet Dent 6: 178-187.
3. Faunce FR, Myers DR (1976) Laminate veneer restoration of permanent incisors. J Am Dent Assoc 93: 790-792.
4. Dietschi D, Ardu S, Krejci I (2006) A new shading concept basedon natural tooth color applied to direct composite restorations.Quintessence Int 37: 91-102.
5. Rochette AL. A ceramic restoration bonded by etched enamel and resin for fractured incisors. J Prosthet Dent 1975; 33:287–293.