- Apply composite resin of the desired shade to the labial surface and roughly shape
it into all areas with a plastic instrument, then use a brush lubricated with unfilled
resin to 'paddle' and smooth it into the desired shape. Cure 60 s gingivally, 60 s
mesioincisally, 60 s distoincisally, and 60 s from the palatal aspect if incisal coverage
has been used. Different shades of composite can be combined to achieve good
matches with adjacent teeth and a transition from a relatively dark gingival area to a
lighter more translucent incisal region (540HFig. 10.7 (c)). - Flick away the unfilled resin holding the contour strip and remove the strip.
- Finish the margins with diamond finishing burs and interproximal strips and the
labial surface with graded sandpaper discs. Characterization should be added to
improve light reflection properties (541HFig. 10.7 (d)).
The exact design of the composite veneer will be dependent upon each clinical case,
but will usually be one of four types: intraenamel or window preparation; incisal
bevel; overlapped incisal edge; or feathered incisal edge (542HFig. 10.8).
Tooth preparation will not normally expose dentine, but this will be unavoidable in
some cases of localized hypoplasia or with caries. Sound dentine may need to be
covered by glass ionomer cement prior to placement of the composite veneer.
543HFigure 10.9 (a) and (b) show an example of successful composite veneers that have
been in place for 5 years. Studies have shown that composite veneers are durable
enough to last through adolescence until a more aesthetic porcelain veneer can be
placed. This is normally only considered at about the age of 18-20 years when the
gingival margin has achieved an adult level and the standard of oral hygiene and
dental motivation are acceptable.
544H
Fig. 10.7 (a) A young patient with amelogenesis imperfecta. (b) Contoured matrix
strip in position. (c) Incremental placement of dentine shade composite. (d)
Postoperative view showing final composite veneers.