Planejamento em facetas de porcelana: parte 2: preparação dental, a chave do sucesso / Designing porcelain laminate veneers: part 2: tooth preparation, the key of success

O alto grau de estética alcançado com facetas de porcelana, não só pela característica óptica natural inicial, mas principalmente por se manter o efeito obtido ao longo dos anos, tornou-as indicadas em várias situações clínicas, entre as quais está a substituição de facetas de resina composta. Estudos clínicos e testes laboratoriais têm ajudado a comprovar que os laminados cerâmicos são uma excelente forma de restabelecer a estética e a função de dentes anteriores de forma conservadora, pois geralmente o preparo se restringe apenas à porção vestibular do esmalte. As etapas clínicas para a confecção de uma faceta de porcelana são apresentadas e discutidas, na tentativa de demonstrar as possibilidades dessa modalidade restauradora...

The high level of aesthetics achieved by the use of porcelain laminate veneers is explained not only by the initial natural optical features, but by the maintenance over the years. This has made porcelain veneers indicated in several clinical situations. Among these indications are replacing resin composite veneers. Clinical and laboratory tests have helped to show that the ceramic veneers are an excellent approach to conservatively restore aesthetics and function of anterior teeth because the preparation is only restricted to enamel in the labial aspect. Thus, the clinical steps for a porcelain veneer treatment will be presented and discussed in an attempt to demonstrate the possibilities of this restorative approach...

Clinical evaluation of 4% hydrogen peroxide bleaching in mandibular teeth

Introduction: Bleaching agents have been constantly introduced into market; however, the efficacy of new hydrogen peroxides still needs to be evaluated. Objective: The aim of this study was to evaluate in vivo the effectiveness of 4% hydrogen peroxide bleaching agent in color change, bleaching maintenance, tooth sensitivity, and patients' satisfaction. Material and methods: Forty subjects were selected, lower bleaching trays were constructed, and the patients were instructed to apply 4% hydrogen peroxide bleaching agent at home. Shade measurements of the mandibular anterior teeth were carried out with a spectrophotometer and Vita Classical shade guide (VITA) at the following moments: baseline, 14 days, after patients' satisfaction, and after 90 days. In addition, tooth sensitivity was evaluated using a visual analogue scale (VAS) at the first 14 days. Shade measurements were submitted to repeated measures ANOVA with Bonferroni adjustment and level of significance set at 5%. Results: Statistically significant differences were found for mandibular tooth shade after at-home bleaching (p < 0.001). After 14 days of bleaching, 90% of the subjects were not pleased with the achieved bleaching; however, after 27 days most of the patients reported to be satisfied. Tooth sensitivity was reported to range from 1.01 in a scale from 0-10. Conclusion: At-home bleaching using 4% hydrogen peroxide is effective in lower teeth with reduced tooth sensitivity.

Planejamento em facetas de porcelana. Parte 1: reforço do remanescente dental / Treatment planning using porcelain laminate veneers. Part 1: reinforcing the tooth remnant

O desenvolvimento da odontologia adesiva, associado à capacidade de condicionar-se a cerâmica e assim obter alta união aos tecidos dentais, tornou possível restaurar dentes anteriores esteticamente comprometidos, por meio de laminados cerâmicos. A restauração de dentes tratados endodonticamente é um procedimento complexo, que se torna mais complexo ainda, quando se seleciona a cimentação adesiva de pinos intra-radiculares. Este artigo, que é a primeira parte de dois trabalhos, apresenta um relato de caso do restabelecimento da resistência do remanescente dental enfraquecido, para dar condições de realização de faceta de porcelana no incisivo central superior.

The achievements in adhesive dentistry associated to surface treatment of ceramics (e.g. etching and signalization) to obtain high bond strengths to dental tissue make possible to restores anterior teeth with porcelain laminates veneers. Restoring endodontically treated teeth is a complex procedure, especially when fiber post cementation procedure is selected. This article is the first part of two that show a case report where dental tissue remaining was reinforced to make possible planning a laminate veneer on upper central incisor.