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CDEN0109

14 I I case study _ mini veneers The preparations remain almost entirely in enamel, which is important from a longevity standpoint. The longevity of a bonded veneer is in correlation with the amount of enamel substrate supporting it. The den- tine–enamel junction is very important for the struc- tural strength of the tooth because it is regarded as a fibre-reinforced bond. When our preparations lay on enamel,thetoothwillnotflex.However,ifwefinishour preparation on large amounts of dentine, we will not only create bonding issues and possibly cause endodonticproblems,butwewillalsoincreasetheflex- ing of the tooth structure. When a rigid material like a porcelainveneerisbondedontop,thedifferenceinthe rigiditymaycausethelutingresinatthemargintostart peelingoffslowlyinfunction.Inthesesituations,wewill mostlikelyendupwithsomemicro-leakageordelami- nation. In order to avoid these problems, we have to be very precise and careful in case selection and tooth preparation. Minimally-invasive, controlled reduction techniques have been developed to safeguard tooth structure10 and increase the veneer treatment progno- sis, while still delivering the designed final aesthetic result. Thisarticlepresentsacasereportfeaturinganindi- rect treatment approach using non-invasive mini porcelainveneerstoenhancetheaestheticsofthesmile asanalternativetodirectcomposites. _Case report A36-year-oldfemalepatientpresentedforacon- sultationconcerningheranterioraesthetics.Shewas not pleased with the palatal position of her right lat- eral incisor (Fig. 1). Owing to her profession—she works as a violinist with regular TV appearances—she often performs in studios, where the lights accentu- atethedarkspaceintheareaofthelateralincisor.She alsowantedtocorrectthepointedincisaledgesofher uppercanines(Fig.2).Apartfromreportingthesespe- cific problems, the patient requested an overall enhancement of her smile. A main concern of the patient was that all treatment should be done with- out preparing any of her teeth. On examination, there was an anterior open-bite. Whenthepatientwasincentricocclusion,shedidnot contactthelateralincisorsandcanines.Eventhough, orthodontic treatment was the ideal choice for restoringthiscase,thepatientfeltshedidnotwantto undergo this type of treatment at this time. The aesthetic problem could be corrected using either composite resin or porcelain. Porcelain was chosen for this case, as the patient is a frequent cof- fee drinker and was concerned about possible future discolouration. Feldspathic porcelain offers superior colourstabilityandphysicaldurabilitycomparedwith composite resins. It can also be manufactured in very thinlayers,allowingforaveryconservativereversible treatment. Full-arch impressions were taken using a vinyl polysiloxane material, and casts were poured (Figs. 3 & 4). No gingival retraction was needed because all margins were supra-gingival. No provisional veneers were fabricated. A diagnostic wax-up was made (Figs. 5 & 6) for evaluativepurposes.Wedecidedtoelongateteeth11 and 21 by adding and simultaneously shaping up the incisal edges, and increasing the bulk of the contour facially, to complement the appearance. We also addedbulktotooth12,tomakeitpartofthearch,and shaped the facial contour of tooth 22 similarly. In addition, we added a little bit of bulk mesially to the incisal edges of the canines, in order to minimise the pointedincisaledges.Allchangesinthecontourwere Fig. 9_Try-in of the facings to evalu- ate their fit. Fig. 10_Frontal view of the cemented veneers. Fig. 11_Occlusal view of the cemented veneers. cosmeticdentistry 1_2009 Fig. 9 Fig. 10 Fig. 11