CDEN0109

I 15 case study _ mini veneers I cosmeticdentistry 1_2009 additive and no teeth needed to be prepared. The veneers were manufactured in the laboratory using IPS d.SIGN porcelain (Ivoclar Vivadent), keeping the same shape as the wax-up model. A full facial cover- age porcelain veneer was manufactured in teeth 12 and 22. Very thin porcelain edges were fabricated in teeth 13, 11, 21, and 23 (Figs. 7 & 8). The porcelain veneers were first tried to evaluate their fit (Fig. 9). Using glycerine try-in gels (Variolink Veneer,IvoclarVivadent)theaestheticappearancewas also evaluated. The transparent Variolink glycerine gel (MV0)waschoseninthiscaseasthemostappropriate for aesthetics, and therefore, the equivalent transpar- ent luting resin (MV 0, Variolink Veneer, Ivoclar Vivadent) was picked as the cementation medium of choice. A retraction cord (Ultrapak E #00, Ultradent) was placed to prevent gingival fluids from contami- natingtheteethduringthebondingprocess. The surface of the teeth was cleaned with pumice and then the teeth were acid-etched for 30 seconds with 37 per cent phosphoric acid gel. A bonding agent wasthenapplied(Heliobond,IvoclarVivadent)accord- ing to the manufacturer’s instructions. The internal aspect of the veneers was treated with 5 per cent hy- dro-fluoric acid for 30 seconds, then silane treated (Monobond-S, Ivoclar Vivadent) for an additional 30 seconds,andfinallyair-driedwithwarmairtoincrease the bond between the ceramic and bonding resin. A bonding agent (Heliobond, Ivoclar Vivadent) was applied over the dried, silanated fitting surface. After gentlyairthinningthebondingagent,thetransparent luting resin (MV 0, Variolink Veneer System, Ivoclar Vivadent) was placed inside the veneers, and the ve- neerswereplacedontheteeth.Excesslutingcompos- itewasremovedwithabrushandtheneachveneerwas cured for 3 seconds before additional excess resin was removedwhilestillingelform.Dentalflosswasusedto removeexcessresinfromtheinterproximalareas. Finalcuringwasaccomplishedbyusingthecuring light on the facial and lingual surfaces of each tooth. Carbide-finishing burs (Safe End Tapered Round, SS White)wereusedtoremoveexcesslutingresinatthe margins and then aluminium oxide polishing strips were used to smooth these areas. Occlusal adjust- ment was accomplished with carbide-finishing burs (SS White Flame). Diamond and silicone carbide- impregnated rubber polishing cups and points were used to polish all surfaces (Jazz P3S, SS White). The final images can be seen in Figures 10 and 11. Theveneersweremanufacturedinharmonywiththe patient’s face and overall appearance (Fig. 12). The aesthetic demands of the patient were met, no teeth were prepared, and an overall enhancement of the smile was achieved. _Conclusion The adoption of non-invasive methodology during aesthetictreatmentisinagreementwithnotonlyethi- calconsiderationsbutalsophysiologicalones.Byusing non-invasive mini porcelain veneers, we are able to enhance the smile of patients, with a completely reversibleapproach,withoutremovinganyoftheirnat- uraltoothstructureandthereforewithnointerference with the physiology of their teeth. Owing to the presence of enamel under the whole fitting surface, bonding procedures are very strong and the flexural properties of the underlying natural teeth are also un- changed;thus,theyareexpectedtolastformanyyears. Naturally, non-invasive methodology cannot always be adopted because of various clinical situa- tions and treatment demands. Nevertheless, when- ever possible, additive procedures should be pre- ferredtoresectionalones. Our smile design deviates from the ‘one-smile-fits- all’, ‘denture look’ approach. We aim to create smiles thatsafeguardtheindividualityandvariabilitythatnat- ural aesthetics exhibit and that are always in harmony withtheuniqueappearanceandstyleofourpatients._ _Acknowledgements I would like to thank August Bruguera, MDT, for undertakingallthetechnicalworkinthiscase. Editorialnote:Acompletelistofreferencesisavail- ablefromthepublisher. Fig. 12_Patient showing her new smile. DrDinosKountourasisthefounderandpresidentof the Hellenic Academy of Aesthetic Dentistry (EAAO). Hecanbecontactedatdinos@kountouras.com. cosmeticdentistry _author info Fig. 12