In this clinical case, Stefan Koubi presents “The No-Prep Approach”, bleaching the patient’s teeth before starting the case to increase the aesthetic integration of chips.
First Steps & Whitening
A mock-up is created with chemical cure composite (Luxatemp Star, DMG) to visualise the aesthetics. Of course the final result must fulfill biological and functional criteria. (Fig 6.)
Laminate veneering is chosen to enhance tooth 12 (Fig 7.)
After bleaching with 5% carbamide peroxide (White Dental Beauty, Optident), slight preparation is performed to follow prep-less concept in order to visualise the cervical margin. Increasing the colour value is key to improving aesthetic integration and imitation of restorations (Fig 8.)
About White Dental Beauty
White Dental Beauty has a range of high quality tooth whitening gels includes 6% hydrogen peroxide and 5% 10% & 16% carbamide peroxide with NOVON, providing great versatility and clinical freedom to whiten patients’ teeth with as little as 30 minutes a day active treatment. Powered by NOVON, which uses an intelligent pH acceleration for maximum whitening effect, speeding up the whitening process whilst still being highly effective.
NOVON is a new, patented whitening compound that comprises hydrogen peroxide, urea and sodium tripolyphosphate and is the active ingredient in a new generation of tooth whitening gels. NOVON has a unique inherent feature in that, on application, it produces a ‘pH jump’ into the alkaline pH range. This ‘pH jump’ enhances the release of perhydroxyl ions which give a faster whitening effect. NOVON – containing gels can therefore produce a similar whitening effect within a shorter timeframe, in comparison to whitening using a regular gel. Alternatively, within the same time frame, a similar level of whitening can be achieved using a lower concentration of NOVON (Hyland et al., 2014). This should be an advantage to patients with sensitive teeth.
NOVON has 4 options for home bleaching:
- 6% Hydrogen Peroxide from as little as 30 minutes a day
- 16% Carbamide Peroxide from as little as 60 minutes a day
- 10% Carbamide Peroxide 2-4 hours overnight
- 5% Mild Carbamide Peroxide 2 hours a day
As mentioned previously, in this case, White Dental Beauty 5% carbamide peroxide was used.
A no-prep approach was chosen for teeth 11 and 21 (Fig 9.)
No-prep restorations are made with e.maX press and then polished. No stain is required. (Fig 10.)
Note the opalescence of the material. (Fig 11.)
Try-in of the three restorations with glycerine paste (Vitique veneer B1, DMG ) (Fig 12.)
Individual dam (Nictone 212, Hu-Friedy) (Fig 13.)
Placement of the chip prior to laminate veneer. Margins are polished with silicone wheel using a low-speed handpiece. (Fig 14.)
Use of Optrasculpt pad (Ivoclar Vivadent) with a soft pressure on the restoration (Fig 15.)
Individual dam for bonding of the laminate after the chip, because it is less fragile (Fig 16.)
Same procedure for the placement of the laminate veneer on tooth 12 (Fig 17.)
Optical integration of both restorations (Fig 18.)
Close-up of the lateral (Fig 19.)
Final result (Ceramist, Gerald Ubassy) (Fig 20.)
Before and after (Fig 21.)
No Prep Restorations
No-prep restorations can be very useful in contemporary treatment planning as they are able to solve some everyday cases. However, it is important to integrate this type of restoration into a basic workflow in which it is simple for both the technician and the dentist to achieve in a feasible and repeatable way.
The role of the dentist as a smile architect is fundamental in order to visualise the ideal pink/black/white ratio for top quality aesthetics and biological preservation.
White Dental Beauty Teeth Whitening Gels are specifically formulated, packaged and delivered with your patients in mind, ensuring you have everything you need to offer them a successful whitening treatment.
White Dental Beauty's whitening products are available worldwide from your local distributor including Optident for the UK. To order in the UK visit the White Dental Beauty manufacturer page or call +44 (0) 1943 60 50 50.
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