537H
Fig. 10.6 (a) and (b) Well-demarcated
white opacities on the upper central
incisors treated by localized composite
restorations.10.2.7 Composite resin veneers
Although the porcelain jacket crown (PJC) may be the most satisfactory long-term
restoration for a severely hypoplastic or discoloured tooth, it is not an appropriate
solution for children for two reasons: (1) the large size of the young pulp horns and
chamber; and (2) the immature gingival contour.
Composite veneers may be direct (placed at initial appointment) or indirect (placed at
a subsequent appointment having been fabricated in the laboratory). The conservative
veneering methods may not just offer a temporary solution, but a satisfactory long-
term alternative to the PJC. Most composite veneers placed in children and
adolescents are of the 'direct' type, as the durability of the indirect composite veneers
is as yet unknown.
Before proceeding with any veneering technique, the decision must be made whether
to reduce the thickness of labial enamel before placing the veneer. Certain factors
should be considered:
- Increased labiopalatal bulk makes it harder to maintain good oral hygiene. This
may be courting disaster in the adolescent with a dubious oral hygiene technique. - Composite resin has a better bond strength to enamel when the surface layer of
200-300 mm is removed. - If a tooth is very discoloured some sort of reduction will be desirable, as a thicker