Historically, porcelain veneers have been an effective treatment option. In addition to preserving tooth structure, adhesive technologies offer excellent options to improve both the esthetic and restorative needs of the patient. As dental materials and techniques have improved, porcelain veneers provide durable, aesthetic, and structural improvements to a person’s smile. These dental restorations alone provide exceptional results, and when coupled with other treatment options, can offer patients remarkable conservative options.
The following case study was submitted by Dr. Katie Sugar of Sugar Family Dental.
The patient presented with teeth crowding, overlapping, and irregularities. Tooth #9 had been endodontically treated and was very dark. The patient wanted to improve his smile, specifically wanting to achieve a straighter, whiter, and more balanced smile. However, the patient did not want to have any crown preparations and indicated that he would like to take as conservative an approach to his case as possible.
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Dr. Sugar began the case using Invisalign to move the patient’s teeth to an ideal position. Invisalign and other clear aligner therapies are excellent options for correcting malocclusions and aligning teeth to a more esthetic and functional position. This patient had some crowding, a common issue associated with malocclusion. In most mild to moderate crowding cases, clear aligners are effective in repositioning the teeth. Additionally, Dr. Sugar performed tooth whitening to lighten the teeth as much as possible, which helped achieve the final results.
The Next Challenge
At this point, great improvements had already been made to the patient’s smile. The next challenge was to restore teeth 8 and 9 using veneers. The patient had previously indicated he did not want any crown preparations. His goal was to achieve the desired results as closely as possible using the most conservative techniques.
It was decided that IPS e.max layered veneers would be the best option to mask the discoloration of tooth number 9 and provide the best match to the surrounding dentition. IPS e.max has been used in dentistry for over 30 years. It is a great restoration for this type of case, as it comes in a variety of translucencies and shades.
IPS e.max provides excellent esthetic results and precise fit. A 500MPa flexural strength makes it a long-lasting restoration.
Additional benefits of IPS e.max include:
Shade Selection
Select the correct Emax ingots and provide the ideal shade match. The following information must be provided. This will ensure that the patient’s color expectations are met.
Specifically, the following should be provided:
With this information in hand, the Smiles by Design team at Burbank Dental Lab was able to select the corresponding Emax ingot that provided the closest color match while masking the dark underlying stump shade present on tooth #9.
Burbank Dental Lab Fabrication
After the case was prepared with veneer preparations, it was digitally scanned using an Itero scanner and uploaded to the digital portal on the Burbank Dental Lab website.
The case fabrication process began with the following steps:
Thank you, Dr. Katie M. Sugar, DMD
Dr. Katie Sugar, DMD
Burbank Dental Lab is very grateful to Dr. Katie Sugar of Sugar Family Dental for giving us the opportunity to work with her on this case. The results of this case are outstanding, largely due to effective planning and adherence to the necessary communication steps to achieve a successful outcome. Working with the patient’s desires to remain conservative provided an excellent starting point with respect to tooth position and shade.
Successful cases follow a proper preparation design, appropriate material selection, patient input, and the use of knowledgeable technicians who can mimic the surrounding dentition with the given materials. If you have any questions regarding your next case, please call or chat with a Smiles by Design team member at Burbank Dental Lab.
Burbank Dental Lab would like to thank Dr. Katie Sugar for providing the notes and photos for this case and for giving us permission to use them.
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