DIRECT VENEERS - FROM DESIGN TO IMPLEMENTATION
Figure 5 . After creating the mock-up , it is possible to do corrections intraorally upon the patient ’ s request
Figure 6 . Enamel prepared off to 45 degrees and the silicon key
Figure 7 . The completed palatal enamel
Figure 8 . Upon the patient ’ s request , we wanted to give the frontal teeth a youthful characters and that ’ s how we applied the dentin color shade , too .
Figure 9 . Restoration after applying the enamel layer
2 . Case report
In our example case , the patient was a 58-year old female , who visited the clinic with frontal teeth damaged by attrition . She had a good and stable periodontal situation , did not smoke and had no other illnesses . In terms of functional pathology , no abnormities were found , therefore no other treatment was necessary . We assume that abrasion had been caused by a previous ( already removed ) bridge in the lateral region and bruxism induced by it ( Fig . 1 ). Our goal was to restore a harmonious smile , taking into account the principles of Visagismo . Based on intensive communication with the patient , we managed to find a balance between her requirements and what was feasible . After long talks with her , we chose the square tooth shape , being characteristic of a primarily “ phlegmatic ” temperament , as the basis of the further stages of the design process ( Fig . 2 ). It was inevitable to take the patient ’ s age into
Figure 10 . The character of the teeth matches the requirements of the original plan
account . Younger patients ’ smiles are generally characterized by longer , rectangle-shaped central incisors , more marked edges , mamelons , HALO effects , visible perikymata and surface grooves , brighter colors , etc . ( Fig . 3 ) These characteristics are different in older patients . Incisors tend to be shorter , and individual features ( edge transparency , mamelons , HALO effect , perikymata , etc .) are significantly less or not at all visible on the teeth . 4 The diagnostic wax-up was produced by the dental technician with these in mind and computer-aided design . The visualization plan created was discussed with the patient in detail and we outlined the options to her . After the diagnostic wax-up , the silicone impression key was created in order to manufacture the intraoral mock-up ( Fig . 4 ). 5 During the next session , the mock-up was created , which we used to demonstrate to the patient her later treatment options . By re-shaping the mock-
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