Clinical
aesthetic results Achieving optimal
N
on-prep veneers continue to be one of the biggest challeng es in aesthetic
veneering treatment because they demand a high degree of intensive diagnosis, optimal conditionsw, c l e a r communi c a t ion and dental technology of outstanding quality. Though they have been
around for 20 years and are well established in the US and UK, the body of data in the literature is still relatively sparse, with a PubMed search using the keywords “non-prep veneer” yielding only ı4 entries. However, this type of
treatment remains one of the most gentle and least invasive methods in cosmetic dentistry. Moreover, the shift towards older patients seeking such cosmetic treatment is increasing. This clinical case study describes the use of non-prep veneers for a difficult aesthetic situation while achieving optimal aesthetic rehabilitation.
Case study A 65-year-old patient, whom we have treated for a number of years, came to us after previously receiving a crown on tooth 22 with the request to have tooth 2ı restored too. Her medical history did not reveal any particular abnormalities, she had good oral hygiene, no allergies and was a non-smoker.
Black-and-white image showing tooth texture and size Fig 1
Professor Dr Marcel Wainwright and ZTM Shahab Esfarjani discuss non-prep veneers with differences in tooth width in the anterior region
Fig 2
Lip profile of the patient before treatment
As can be seen in Figure ı,
both central incisors in the cervical third had enamel hypoplasia and vertical cracks in the enamel. At the same time, tooth 2ı appeared shorter on the incisal edge than tooth ıı due to its palatally retruded position. A black- and-white image is useful here so that the surface texture becomes more obvious. Because the patient is an artist with a keen aesthetic
Close-up of the anterior teeth showing details of the shade changes Fig 3
eye, clear communication and pre-diagnosis were essential to avoid disappointment or overly high expectations. What was interesting was
that the patient only sought treatment of the maxilla and was satisfied with the appearance of the mandible and did not want any treatment of the mandibulary teeth. After clarif ication,
consultation and suggestions for treatment alternatives, the
patient finally opted for two non-prep veneers on teeth ıı and 2ı. The lip profile of the
65-year-old patient (Fig 2) reveals a youthful appearance around the mouth, with healthy and bright teeth. The close-up colour image of
the maxillary anterior situation (Fig 3) illustrates the details of the shade changes in the
Continued » Ireland’s Dental magazine 35
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