This clinical case presents the step-by-step of office whitening and rehabilitation with composite resin veneers in a patient with wear due to bruxism.
Author: Dr. Felipe Pinto Paredes Rodrigues
FEMALE PATIENT, 27 YEARS OLD
She was dissatisfied with the aesthetics of her smile due to tooth wear and yellowing of the teeth.
Initial evaluation
After anamnesis and clinical examination, it was found the presence of a smile with an aged appearance due to wear and dental fractures. The patient had restorations in good condition, without infiltrations or active caries.
Treatment performed
An intraoral scan was performed aiming to plan for aesthetic rehabilitation with composite resin aesthetic veneers. The planning was tested and approved by the patient. The restorative test (mockup) was performed with PrimmaArt bisacrylic resin in Bleach color.
Treatment began with three tooth whitening sessions using Whiteness HP Blue whitening gel. The whitening gel was applied for up to 40 minutes per session, following the manufacturer’s recommendations, and thus, we could observe a change in color from B1 to BL3. Whiteness HP Blue was chosen because the patient reported a history of hypersensitivity when performing in-office dental whitening with another professional.
with another professional. In the session following the completion of the whitening, the aesthetic veneers were performed using Vittra APS resins in EBL3 and DBL3 colors, both in enamel opacity and dentin opacity, in order to obtain a lighter color but with a natural aspect.
To perform the veneers, a silicone guide was made to assist in reproducing what was planned. The result achieved was to the patient’s liking, who is perfectly adapted and satisfied with the new smile.
Step by step of whitening
1 | Aesthetic planning – Mockup with PrimmaArt.
2 | Initial shade taking.
3 | Dental whitening procedure with Whiteness HP Blue
4 | Shade taking after whitening.
5 | Insulation for making resin veneers
6 | Application of Condac 37 phosphoric acid for 15 seconds.
7 | Application of the Ambar APS adhesive.
8 | Palatal layer with Vittra APS – Trans OPL and mesial and distal contour with Vittra APS color EBL3.
9 | Dentin layer with Vittra APS color DBL3
10 | Assist APS Modeling resin for better handling of the composite.
11 | Markings of the slopes and edges to guide the finishing step.
12 | Correction of edges with a sanding disc of greater granulation Diamond Pro.
13 | Conducting the effect of textures with a multilaminated drill.
14 and 15 | Polishing with rubber spirals.
16 and 17| Initial and final smile.
Check out how to manipulate the Whiteness HP Blue office whitening gel!
Products used
