Correction of chromatic change in anterior tooth using the direct-indirect technique for composite resin veneers: case report

Abstract

Introduction: Advancements in composite resins have enabled the development of new techniques for the treatment of esthetic alterations. Among these, the direct-indirect technique for making veneers has gained prominence  for providing restorations with better physical-mechanical properties and greater esthetic predictability compared to conventional techniques, as indicated by several studies. Objective: To describe, through a case report, the application of the direct-indirect technique with light-cured composite resin for the treatment of a single darkened anterior tooth linked to shape alterations in adjacent teeth. Case Description: A 27-year-old female patient came to the clinic complaining of the darkening of tooth 21 and a history of previous treatment failures. The inadequate restoration on tooth 21 was removed using multilaminated burs at low rotation. The new restorations were fabricated through the direct-indirect technique and using Opaquer (Forma), A1D (Empress Direct), and BL-L E (Empress Direct) resins, respecting the stratification with different opacity levels on teeth 11, 12, 21, and 22. The restorations were initially fabricated without adhesion, allowing for finishing and polishing in an extraoral environment. Cementation was carried out using Ambar Universal Adhesive (FGM) and Opus Bulk Fill Flow resin (FGM), following the manufacturer's recommendations regarding substrate conditioning and light-curing time. Conclusion: The direct-indirect technique proved to be highly effective for the treatment of darkened teeth, especially due to the possibility of predicting the esthetic outcome before cementation. In addition, it proved effective in correcting shape alterations in anterior teeth, restoring their function and esthetic sensibilities and the patient's self-esteem.