Initial situation: The 40 year old female patient presented because she was not satisfied with the appearance of her front teeth (Figs. 1 – 2). The diagnostic stage was achieved in a two-step approach including the elaboration of a diagnostic wax-up and the production of a corresponding template to be evaluated in vivo by the patient and the clinician.

Treatment plan: The wax-up starts by defining the vertical dimension of the teeth. Basic tooth shapes are determined by the vertical proximal crests, the differential placement and contouring of the transition line angle can easily generate the illusion of a shorter or wider tooth. The second step of the wax-up procedure is to create the horizontal component of surface topography (Fig. 3). Also a diagnostic mock-up is performed. On the wax-up, a highly accurate silicon index is made and placed on the unprepared teeth with self-curing composite material (Figs. 4 – 5). Subsequently a heat-processed acrylic provisional is fabricated on the basis of the wax-up.



After the preparation, a chamfer finish line and a palatal butt margin are created which provide the margin of the restoration with a strong bulk of porcelain. Due to the original prominence of the teeth, dentin exposure can not be avoided (Fig. 6). Prior to the precision impression the dentin is immediately sealed with adhesive. Two retraction cords are placed and the 1-step impression technique with Impregum Penta Soft Polyether Impression Material (3M ESPE) provides an exact reproduction of the preparations and the surrounding tissues (Fig. 7). The heat-processed provisionals are relined and cemented with RelyX Temp NE Temporary Cement (3M ESPE). To cement the veneers RelyX Veneer Cement (3M ESPE) was applied, followed by gentle air thinning.



Each restoration is seated with gentle finger pressure while excess cement is removed from the margin. Light curing starts at the palatal aspect followed by the buccal aspect. Subsequently an air barrier is applied to the margin. The sequence is repeated incrementally for one veneer after the other. The margins of the final restorations are polished and the occlusion is checked (Figs. 8 – 9).

Author : Elie Zebouni