A case of implant superstructure and laminated veneer restoration of adjacent tooth in consideration of color harmony

Abstract

Case summary: It is common to perform esthetic restorations of maxillary anterior teeth using different prosthetic materials for the left and right sides, but it is often difficult to match their color tones. In this paper, we report a case of esthetic restoration using a cement that can reproduce color tones focusing on luminosity. Treatment strategy: The patient, a 59-year-old woman, came to our clinic because of dehiscence of resin prosthetic crown in #11. After obtaining the patient's explanation and consent, it was decided to place an implant and all-ceramic crown on #11 and porcelain laminate veneers on #21 tooth after extraction. Course of treatment: After orthodontic extrusion of #11 to facilitate the alignment of the right and left cervical lines, the implant was placed immediately after extraction. After confirming the osseointegration of the implant, a provisional restorations were fabricated based on the diagnostic wax-ups of #11 and #21, and a porcelain laminate veneer was prepared using the flowable resin technique. After the veneer preparation, the remaining enamel was checked using a chairside SEM observation system, and the veneers were bonded using dental resin cement. Considerations and conclusions: The additional fabrication of a diagnostic wax-up made it possible to reduce the volume of the wax model, thus allowing more enamel to remain and improving long-term bonding expectancy of porcelain laminate veneer. The color tone of all-ceramic crowns is also affected by the color tone of the supporting teeth and bonding materials. Porcelain laminate veneers may be more affected by the cement color because of their thinness. Since luminosity affects color tone, a cement allowing adjustment of luminosity may be useful. The cement used in this study can be easily matched to the color tone by a simple system of selecting from three colors with different luminosity.