Injectable Flowable Resin-based Composite Veneers Prior to Ceramic Veneers
This case report describes the clinical protocols for using injectable flowable resin-based composite veneers without tooth reduction as long-term prototype restorations, followed by conservative feldspathic veneer restorations. The patient’s primary concern was to improve her smile. After clinical evaluation, injectable flowable resin composite veneers were recommended as long-term prototypes followed by conservative tooth preparation and ceramic veneers. Flowable composite veneers were created with a transparent silicone index fabricated from a diagnostic wax-up approved by the patient. No tooth reduction was required to place this type of composite veneer. Later, a printed reduction guide was used to provide conservative tooth preparation followed by the cementation of thin feldspathic porcelain veneers under full isolation with a rubber dam. Injectable flowable resin-based composite veneers can successfully act as long-term esthetic prototypes before ceramic veneers. The outcome of these restorations is very predictable because the diagnostic wax-up anatomy is transferred to the mouth through the transparent silicone index, and they can be placed without tooth reduction. Conservative tooth preparation can be performed on the composite veneers so that minimal tooth structure is removed to maximize the bonding performance of ceramic veneers.SUMMARY
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Initial intra-oral views. (A) Initial smile close-up; (B) initial intra-oral frontal view.
Sequential illustration of the fabrication of silicone matrix guide and injectable composite veneer. (A) Putty guide on diagnostic wax-up; (B) silicone matrix guide for injectable flowable composite veneers; (C) silicone matrix in place on the teeth; (D) Teflon tape isolation; (E) phosphoric acid etching; (F) adhesive application; (G) injectable flowable composite build-up.
Sequential illustrations of polishing for injectable flowable composite veneers. (A) Polishing of interproximal area; (B) polishing using silicone polishing cup; (C) polishing using diamond paste; (D) final polishing using goat hair wheel; (E) finalized composite veneers.
Injectable flowable composite veneers. (A) Front view one week after polishing; (B) left side view one week after polishing; (C) front view at three-year follow-up; (D) left side view at three-year follow-up.
Sequential illustrations of ceramic veneer preparation. (A) Groove reduction guides for conservative veneer preparation; (B) conservative tooth preparations; (C) printed reduction guide; (D) polishing final tooth preparations.
Sequential illustrations of taking impressions. (A) Final polished tooth preparations; (B) final impression with heavy and light body PVS materials.
Sequential illustrations of fabrication of porcelain veneers. (A) Stone model of prepared teeth; (B) fabricated porcelain veneers.
Sequential illustrations of cementation of ceramic veneers. (A) Try-in of ceramic veneers; (B) cementation under rubber dam isolation; (C) cementation under rubber dam isolation close-up; (D) immediate post-operative view.
Intra-oral views at final three-year follow-up. (A) Final smile close-up; (B) final intra-oral frontal view.
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