Quadrant Composites

anterior casus

Diastema Closing Crowding & abrasion Correction of position (veneers)Direct resin venering Crowding and discolorations Class II/2, Incisal wear, discoloration Multiple agenesia, diastema Old restaurations, discoloration and crowding Endodontic discolorations Cross-bite Diastema closing Schisis and missing elements Crown adjustment

anterior casus example

multiple agenesia pre ortho treatment restore length wear restore form & length ortho treatment wear on insisors severe fracture damaged incisor extension lateral incisive Severe abrasion Correction of position (built-up)Replacement of facings (1) Replacement of facings (2)Diastema distal Dentinogenesis Imperfecta Tetracycline discoloration Removal Gold Restoration Poor restorations 2 Poor restorations Paro problem Crown restoration Amelogenesis Imperfecta Severe incisal wear and old crowns Old crown Open bite treatment Tetracycline discoloration Crowding and old restorations Endo-discolorations Poor restoration materials Extreme klasse II/2 Cosmetic restoration blacklight Severe damage Severe wear Drugs abuse Disorder at Birth Veneers Growth disorder Cosmetic adjustment Poor restorations Small defects Defect Bracket fixation Severe wear due to soft-drinks Poor restorations Paro problems treatment Bite correction Black-holes camouflage Restore tooth positions Restore length of lateral incisors Incisor discoloration Discoloration under porcelain restoration Discoloration and crowding Cosmetic make-over Cosmetic restoration

link naar cavex site

Direct resin venering A 41-year-old woman asks for cosmetic treatment of tooth 22. This tooth is positioned so far palatally that it is placed in cross-bite, (without occlusal interferences). Tooth 22 is, as it were, in the shadow of the neighbouring elements and therefore appears darker. After initial periodontal treatment some years ago, there has been some recession of the marginal gingiva. This gingival recession further emphasises the fact that tooth 12 is narrower cervically than tooth 22, partly because of the dark triangles formed by the dark background of the buccal cavity. The patient does not wish any orthodontic treatment, so the only treatment option is to creatively mask the shape and position of teeth 12 and 22. After making a mock-up with composite, it is decided in consultation with the patient, to build up tooth 22 in labial direction by means of a direct composite veneer restoration. Tooth 12 will be built up very locally in proximal direction in order to mask the dark spaces.

	1a. Frontal view of patient with tooth 22 positioned 1alatally and moderate gingiva recession	1b. View from the right. Tooth 12 showes cervical constriction and interdental papillae are flattened	1c. View from the left. Tooth 22 is wider than tooth 12 and is in cross-bite

	2a. A layer of dentine composite is applied, shade OA2	2b. A layer of composite in shade A3, which continues to the cervical outline, ensures the warm, yellowish aspect in the cervical are

	2c. A thin layer of A2 is applied, overlapping, further towards the incisal edge, which provides the basic colour in the central area (less colour saturation, slightly higher value)	2d. Finally, D3 is applied in over lapping layers to produce less saturation towards the incisal edge and provide a slightly bluer aspect (again slightly less colour saturation and lower value)

	3a. An example of composite restorations on teeth 21 and 22, which have been contoured using fine diamond finishing burs	3b. The same restorations as in fig. 4.a, but now finished using a multifluted carbide bur

	4a. Final result of a veneer restoration on tooth 22, immediately after treatment. Light reflections on element 22 are symmetrical and parallel with adjacent teeth	4b. Close-up of a veneer restoration on tooth 22. The surface texture structure is visible more clearly

usefull protocols:

veneer protocol
anterior protocol

Casus by dentist H. Scholtanus