Esthetic treatment of anterior spacing in a patient with microdontia using No-prep veneers: A clinical report

Main Article Content

Pajaree Limothai
Chalermpol Leevailoj

Abstract

Objectives: This case report describes the treatment of a patient with maxillary anterior spacing, resulting from microdontia, using a multidisciplinary approach to improve her esthetic appearance.


Materials and Methods: A 23-year-old Thai female patient had multiple spaces between her maxillary anterior teeth with a high smile line and an unsymmetrical gingival level. The Recurring Esthetic Dental (RED) proportion was used to determine each tooth’s width and Bolton’s analysis was used to confirm the RED results, and a diagnostic wax-up model was fabricated. Esthetic crown lengthening was performed at the right maxillary canine to the left maxillary canine to reduce excess gingival exposure and increase the length of the teeth according to the proportion acquired from the calculation. After complete gingival healing, no-prep ceramic veneers were placed on the maxillary anterior teeth using the IPS Empress® Esthetic ceramic system.


Results: The no-prep veneers preserved all tooth structure and gave a satisfactory esthetic result. The patient was satisfied with the outcome. The final restorations closed the spaces with the natural appearance the patient desired. The function and occlusion of the restorations were good. The veneers and the periodontal tissues were in good condition at the 1-year recall.


 Conclusion: The multidisciplinary approach and no-prep ceramic veneers used in this case restored the maxillary anterior spacing and provided an excellent esthetic outcome. However, successful treatment in the anterior esthetic zone requires a thorough diagnosis and meticulous step-by-step treatment planning.


Keywords: ceramic veneer, maxillary anterior spacing, microdontia, no-prep veneer

Article Details

How to Cite
1.
Limothai P, Leevailoj C. Esthetic treatment of anterior spacing in a patient with microdontia using No-prep veneers: A clinical report. M Dent J [Internet]. 2019 Jul. 5 [cited 2024 May 4];39(2):115-2. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/192540
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Original articles

References

1. Strassler HE. Minimally invasive porcelain veneers: indications for a conservative esthetic dentistry treatment modality. Gen Dent 2007; 55: 686-94.
2. Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology. 1st ed. Philadephia: Saunders; 1958: 26.
3. Neville BW, Allen CM, Damm DD, Chi AC. Oral and maxillofacial pathology. 4th ed. Missouri: Saunders; 2015: 76.
4. Poulsen S, Koch G. Pediatric dentistry: a clinical approach. 2nd ed. Chichester: Wiley-Blackwell; 2013.
5. Niswander JD, Sujaku C. Congenital Anomalies of Teeth in Japanese Children. Am J Phys Anthropol 1963; 21: 569-74.
6. Egermark-Eriksson I, Lind V. Congenital numerical variation in the permanent dentition. D. Sex distribution of hypodontia and hyperodontia. Odontol Revy 1971; 22: 309-15.
7. Bergstrom K. An orthopantomographic study of hypodontia, supernumeraries and other anomalies in school children between the ages of 8-9 years. An epidemiological study. Swed Dent J 1977; 1: 145-57.
8. Brook AH. A unifying aetiological explanation for anomalies of human tooth number and size. Arch Oral Biol 1984; 29: 373-8.
9. Fekonja A. Prevalence of dental developmental anomalies of permanent teeth in children and their influence on esthetics. J Esthet Restor Dent 2017; 29: 276-83.
10. Laverty DP, Thomas MB. The restorative management of microdontia. Br Dent J 2016; 221: 160-6.
11. Bello A, Jarvis RH. A review of esthetic alternatives for the restoration of anterior teeth. J Prosthet Dent 1997; 78: 437-40.
12. Pahlevan A, Mirzaee M, Yassine E, Ranjbar Omrany L, Hasani Tabatabaee M, Kermanshah H, et al. Enamel thickness after preparation of tooth for porcelain laminate. J Dent (Tehran) 2014; 11: 428-32.
13. Layton DM, Clarke M, Walton TR. A systematic review and meta-analysis of the survival of feldspathic porcelain veneers over 5 and 10 years. Int J Prosthodont 2012; 25: 590-603.
14. Dumfahrt H. Porcelain laminate veneers. A retrospective evaluation after 1 to 10 years of service: Part I – Clinical procedure. Int J Prosthodont 1999; 12: 505–13.
15. Gurel G, Sesma N, Calamita MA, Coachman C, Morimoto S. Influence of enamel preservation on failure rates of porcelain laminate veneers. Int J Periodontics Restorative Dent 2013; 33: 31-9.
16. Buonocore MG. A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces. J Dent Res 1955; 34: 849-53.
17. Bowen RL. Adhesive bonding of various materials to hard tooth tissues. I. method of determining bond strength. J Dent Res 1965; 44: 690-5.
18. Bowen RL. Properties of a silica-reinforced polymer for dental restorations. J Am Dent Assoc 1963; 66: 57-64.
19. Gresnigt M, Ozcan M. Esthetic rehabilitation of anterior teeth with porcelain laminates and sectional veneers. J Can Dent Assoc 2011; 77: b143.
20. Gresnigt M, Ozcan M, Kalk W. Esthetic rehabilitation of worn anterior teeth with thin porcelain laminate veneers. Eur J Esthet Dent 2011; 6: 298-313.
21. Miranda ME, Olivieri KA, Rigolin FJ, Basting RT. Ceramic fragments and metal-free full crowns: a conservative esthetic option for closing diastemas and rehabilitating smiles. Oper Dent 2013; 38: 567-71.
22. Lombardi RE. The principles of visual perception and their clinical application to denture esthetics. J Prosthet Dent 1973; 29: 358-82.
23. Bolton WA. Disharmony in tooth size And its relation to the analysis and treatment of malocclusion. The Angle Orthod 1958; 28: 130-3.
24. Ward DH. Proportional smile design using the recurring esthetic dental (RED) proportion. Dent Clin North Am 2001; 45: 143-54.
25. Ward DH. A study of dentists' preferred maxillary anterior tooth width proportions: Comparing the recurring Esthetic dental proportion to other mathematical and naturally occurring proportions. J Esthet Restor Dent 2007; 19: 324-37.
26. Rosenstiel SF, Ward DH, Rashid RG. Dentists' preferences of anterior tooth proportion--a web-based study. J Prosthodont 2000; 9: 123-36.
27. Gargiulo A, Krajewski J, Gargiulo M. Defining biologic width in crown lengthening. CDS Rev 1995; 88: 20-3.
28. Arte S, Nieminen P, Pirinen S, Thesleff I, Peltonen L. Gene defect in hypodontia: exclusion of EGF, EGFR, and FGF-3 as candidate genes. J Dent Res 1996; 75: 1346-52.
29. Kronfeld R, Boyle PE. Kronfeld’s histopathology of the teeth and their surrounding structures. 1st ed. Philadelphia: Lea & Febiger; 1955: 14
30. Geoffrey C, Van B. Dental morphology: An illustrated guide. 2nd ed. Woburn: Butterworth-Heinemann; 1983: 127.
31. Izgi AD, Ayna E. Direct restorative treatment of peg-shaped maxillary lateral incisors with resin composite: a clinical report. J Prosthet Dent 2005; 93: 526-9.
32. Beier US, Kapferer I, Burtscher D, Dumfahrt H. Clinical performance of porcelain laminate veneers for up to 20 years. Int J Prosthodont. 2012; 25: 79-85.
33. Calamia JR. Etched porcelain veneers: the current state of the art. Quintessence Int 1985; 16: 5-12.
34. Quinn F, McConnell RJ, Byrne D. Porcelain laminates: a review. Br Dent J 1986; 161: 61-5.
35. Burke FJ. Survival rates for porcelain laminate veneers with special reference to the effect of preparation in dentin: a literature review. J Esthet Restor Dent 2012; 24: 257-65.
36. Ozturk E, Bolay S. Survival of porcelain laminate veneers with different degrees of dentin exposure: 2-year clinical results. J Adhes Dent 2014; 16: 481-9.
37. Ferrari M, Patroni S, Balleri P. Measurement of enamel thickness in relation to reduction for etched laminate veneers. Int J Periodontics Restorative Dent 1992; 12: 407-13.
38. Christensen GJ. The all-ceramic restoration dilemma: where are we? J Am Dent Assoc 2011; 142: 668-71.
39. Yang, Y, Yu J, Gao J, Guo J, Li L, Zhao Y, et al. Clinical outcomes of different types of tooth-supported bilayer lithium disilicate all-ceramic restorations after functioning up to 5 years: A retrospective study. J Dent 2016; 51: 56-61.
40. Friedman MJ. A 15-year review of porcelain veneer failure--a clinician's observations. Compend Contin Educ Dent 1998; 19: 625-8.
41. Fradeani M, Redemagni M, Corrado M. Porcelain laminate veneers: 6- to 12-year clinical evaluation--a retrospective study. Int J Periodontics Restorative Dent 2005; 25: 9-17.