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Special Issues
July/August 2016
Volume 37, Issue 3

Using a Composite Resin Veneer Template for Predictability and Efficiency

Esthetically improving a smile

It’s common for a patient with an almost perfect smile to want improvements. A 26-year-old female presented with upper congenitally missing first premolars that had been previously restored with implants at an early age. The resultant crowns were unaesthetic. The patient also had demure laterals that had been bonded, but had a slight shade discrepancy. She had small imperfections with the remaining upper anterior teeth that were likely to benefit from conservative cosmetic dentistry.

The treatment plan included the reduction of the facial surfaces of the implant crowns on teeth Nos. 4 and 12 with the intent to immediately bond composite resin to provide a more acceptable texture, shape, and shade. Because the implant for the upper-left first-premolar site was placed at an odd angle, the reduction of the facial surface of this crown was limited, although improvement was seen. At the same appointment, the upper canines, laterals, and centrals were also veneered with composite resin. To ensure uniformity of shape and contour, a composite resin veneer template (UveneerTM, Ultradent Products, Inc., www.ultradent.com) was used.

Esthetically improving a smile can be accomplished conservatively using composite resins. Not only are composite resin restorations beautiful, but when done in a timely manner, they also produce significant profits for the dental office. Using the most appropriate system with a reputable bonding agent ensures their durability. Utilizing Uveneer provided predictability in the shape and contour of the restorations and allowed the case to be completed efficiently.

Key Takeaways

• Utilizing Uveneer provides predictability in the shape and contour of the restorations.

• Uveneer is a unique, minimally invasive template system that creates beautiful direct composite veneers with predictable shape and symmetry—all in one visit.

• Each template mimics natural dentition and is designed to create high-quality natural-looking anterior restorations.

About the Author

Jaimeé Morgan, DDS
Private Practice
Midvale, Utah

Fig 1. To ensure uniformity of shape and contour, a composite resin veneer template (UveneerTM) was used.

Figure 1

Fig 2. Preoperative view of patient smiling exhibits improper contour of implant crowns on Nos. 5 and 12. The laterals are slightly grey in comparison to the canines and the centrals. Tooth No. 11 is tucked lingually, which makes tooth No. 12 appear bulky on the facial.

Figure 2

Fig 3. Preoperative retracted view.

Figure 3

Fig 4. Facial porcelain was removed from tooth No. 5 to allow for composite resin to be bonded to provide better shape and contour.

Figure 4

Fig 5. Teflon tape was used to isolate tooth No. 5. Teflon tape adapts better to the adjacent teeth and is thin enough that it does not interfere with establishment of proximal contacts. KleerViewTM cheek retractors (Ultradent Products) were also used for isolation. Porcelain etch (Ultradent Products) was applied for 1 minute and then rinsed off.

Figure 5

Fig 6. Silane (Ultradent Products) was applied to the porcelain for 1 minute, and then air dried.

Figure 6

Fig 7. Peak® Universal Bond agent (Ultradent Products) was brushed onto the facial surface of the porcelain, air thinned for 10 seconds, and then light cured for 10 seconds.

Figure 7

Fig 8. Vit-l-escence composite resin shade Opaque Snow (Ultradent Products) was applied to tooth No. 5 and shaped. Vit-l-escence is easily manipulated and adapts intimately with the porcelain or tooth surface. Uveneer medium-size template for upper-right first premolar was placed over the uncured composite and pressed into place.

Figure 8

Fig 9. It is recommended to remove as much excess uncured composite around the Uveneer template as possible prior to light curing. However, if access is difficult and prevents removal of the excess composite, it can be easily addressed with the use of diamond mosquito burs (sizes 8392.31.013 and 392EF.31.016) (Brasseler USA) and EP polishing discs (Brasseler USA).

Figure 9

Fig 10. It is recommended to remove as much excess uncured composite around the Uveneer template as possible prior to light curing. However, if access is difficult and prevents removal of the excess composite, it can be easily addressed with the use of diamond mosquito burs (sizes 8392.31.013 and 392EF.31.016) (Brasseler USA) and EP polishing discs (Brasseler USA).

Figure 10

Fig 11. A Jiffy® Proximal Saw (Ultradent Products) was used to ensure a clean contact followed by a metal VisionFlex UF strip (Brasseler USA) to smooth any tags of resin or bonding agent that may be adhering to the proximal wall. Using a courser strip than ultra fine may open the contact.

Figure 11

Fig 12. The upper right canine was restored next by isolating it with Teflon tape and etching with phosphoric acid (Ultra-Etch®, Ultradent Products). Existing composite was removed from the laterals. Using the same steps as discussed in Figure 6 through Figure 9, the upper right canine and laterals were restored. Tooth No. 8 was then isolated with Teflon tape, etched (Ultra-Etch, Ultradent Products) for 15 seconds, and rinsed, and excess moisture was removed.

Figure 12

Fig 13. Peak® Universal Bond agent was applied to the etched tooth, air thinned, and light cured for 10 seconds using Valo® LED curing light (Ultradent Products).

Figure 13

Fig 14. Vit-l-escence composite resin shade Opaque Snow was applied to tooth No. 8 and minimally contoured. Uveneer template was placed over the uncured composite and gently pressed into place. The excess composite from the mesial, distal, and gingival was removed using an IPC. To avoid moving or dislodging the Uveneer template, the excess on the incisal was removed after light curing using an EP polishing disc.

Figure 14

Fig 15. Vit-l-escence composite resin shade Opaque Snow was applied to tooth No. 8 and minimally contoured. Uveneer template was placed over the uncured composite and gently pressed into place. The excess composite from the mesial, distal, and gingival was removed using an IPC. To avoid moving or dislodging the Uveneer template, the excess on the incisal was removed after light curing using an EP polishing disc.

Figure 15

Fig 16. A Jiffy Proximal Saw was used to ensure a clean contact.

Figure 16

Fig 17. A VisionFlex UF polishing strip was used to smooth any tags of resin or bonding agent. Epitex® polishing strips (GC America) were use to put a high shine on the proximal walls and to prevent bonding during the successive veneer placement. The veneers on teeth Nos. 9 through 11 were approached in the same manner. The veneer on tooth No. 12 was treated the same as tooth No. 5 where the porcelain was reduced, etched with porcelain etch, silanated, and coated with Peak® Universal Bond agent.

Figure 17

Fig 18. A VisionFlex UF polishing strip was used to smooth any tags of resin or bonding agent. Epitex® polishing strips (GC America) were use to put a high shine on the proximal walls and to prevent bonding during the successive veneer placement. The veneers on teeth Nos. 9 through 11 were approached in the same manner. The veneer on tooth No. 12 was treated the same as tooth No. 5 where the porcelain was reduced, etched with porcelain etch, silanated, and coated with Peak® Universal Bond agent.

Figure 18

Fig 19. Postoperative smiling view.

Figure 19

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