Catalogue Maquira BM4 - English

DENTAL WHITENING, A GREAT ALTERNATIVE PRIOR TO
AESTHETIC RESTORATIVE TREATMENT
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TREATMENT PERFORMED:
Whitening of the upper and lower frames, using the home-based technique prior to the restorative treatment. Veneers on the
central incisors, ultra thin laminates on the lateral incisors and ceramic fragments on the mesial edges of canines.
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METHODOLOGY USED
TECHNIQUE:
After clinical examination of the patient, the patient's initial photographs were taken (Figure 1 and Figure 2). Good prophylaxis
was performed with the use of ultrasound and bicarbonate jet prior to the replacement of the composite resin veneers of
central incisors.
An upper and lower impression was performed after the resin veneers were
removed. Replaced by new provisional veneers of direct composite resin (Figure
3), however the resin used had a lighter color (A1). The models obtained with the
initial impression. They were used to build two plasticized vacuum trays and the 16%
carbamide gel (Power Bleaching) was used for home-based bleaching.
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The patient's initial color was recorded using the Vita scale (initial color A3). The patient was prescribed to use the bleach
once a day, for a period of 2 hours for 14 days. After the end of this period, a new evaluation was carried out and we chose
to perform the whitening for another 7 days, following the same initial protocol.
After the completion of the whitening, a new color taking was performed. Color B1 was the color obtained with the use of the
bleach. From this moment on, a study for the construction of the new tooth shape was carried out. For this study we used
the DSD concept (developed by Dr. Christian Coachman), seeking a new shape of the teeth, so that they would be directed in
a harmonic way by the patient's facial analysis. To materialize this study, a mockup was carried out with bis-acryl composite
resin color A1. Note in the photograph the new shape of the central teeth, shorter sides (we painted the incisal edge of the
patient's original tooth to create an optical illusion of the side reduction in the mockup) and alteration of the inclination of the
mesial edge of canines (Figure 4).
New preparations for venners were performed on the central incisors. In the lateral incisors small preparations were made
for ultra thin laminates and in the region of the fragments, only polishing of the mesial edge was performed, aiming at the
removal of sharp angles.
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RESULT OF TREATMENT:
The case was finalized with ceramic restorations of
stratified lithium disilicate in color B1. In the central
incisors, 1.5 mm thick veneers (to mask the darkened
color of the dental substrate in the lateral incisors, 0.5
mm thick laminates and fragments on the mesial edges
in the canines(Figure 5 and Figure 6).
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CONCLUSION FROM MY
EXPERIENCE with POWER
BLEACHING:
In our clinical routine, we increasingly indicate
previous performance of tooth whitening in cases of
aesthetic restorative treatments. This allows for the
creation of lighter dental substrates, enabling more
conservative preparations and a more youthful
smile, such as that obtained in this treatment with
the use of Power Bleaching Home 16% carbamide
peroxide gel (Figure 7 and Figure 8).
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