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International Journal of Esthetic Dentistry  (English Edition)



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Int J Esthet Dent 10 (2015), No. 4     24. Sep. 2015
Int J Esthet Dent 10 (2015), No. 4  (24.09.2015)

Page 548-562, PubMed:26794051

The non-vital discolored central incisor dilemma
Schlichting, Luís Henrique / Stanley, Kyle / Magne, Michel / Magne, Pascal
The restoration of anterior teeth is frequently a demanding mission. Patients generally have high expectations for the anterior region, which makes the emotional side of treatment especially important. When this involves discolored endodontically treated teeth, consensus can hardly ever be found as to the chosen approach. Bleaching with direct composites is undoubtedly the most conservative choice for these cases. However, this may require more maintenance (touch-up bleaching and repairs) in the long term, which is an important issue for adult patients. On the other hand, bonded porcelain veneers represent a more 'high-end' option, as they recover the original biomechanics of the intact tooth, allow an optimal masking of the substrate, remain stable, and have a reasonable biological cost when compared to full-coverage crowns. This strategy is explained in this article and documented with a clinical case. We describe treatment planning based on the biomimetic concept, taking into consideration what is possible with current materials and techniques when combined with the patient's particular needs, including the introduction of an innovative step during dentin sealing - the microsuction. The laboratory work was totally accomplished by 'teledentistry', with no direct contact between the dental technologist and the patient.