Clinical application of digital smile design in aesthetic restoration of porcelain veneer of anterior teeth and analysis on its repair effect / 吉林大学学报(医学版)

ABSTRACT

Objective: To analyze the postoperative satisfaction and repair effect of prosthesis of the patients who received digital smile design(DSD) combined with porcelain veneers in the anterior teeth, and to illustrate the their application in anterior teeth aesthetic restoration. Methods: A total of 91 anterior teeth of 32 patients whose clinical diagnosis conformed to the indications of porcelain veneers and aesthetic restoration because of tetracycline pigmentation teeth, dental fluorosis, color stained teeth, enamel defects and anterior teeth space were selected. DSD software was used to design the preoperative aesthetic analysis of the teeth morphology and to show the virtual effect of restoration. The preparation of tooth under the guidance of the design results was finished. The IPS e-max porcelain veneers were prepared after the conventional impression preparation. At last, the permanent restorations were manufactured and bonded to teeth. After the adhesive program was completed, the satisfaction of the patients in the shape of restorations, the degree of coordination with the adjacent teeth, color, pronunciation, smile effect and doctor-patient communication effect were evaluated by the questionnaires. The patients were required to regularly return after one month, three months, six months and twelve months, and observe the clinical effects of restoration was observed referring to the modified American Public Health Service (USPHS) standard. Results: The patients' satisfaction rates of each evaluation content were all over 90%. Among them, the satisfaction rates of the smile effect and the doctor patient communication were as high as 100%. The clinical performances of the rehabilitations in each period were as follows One month after treatment, there were four teeth occurred mild gingivitis and three teeth appeared the postoperative sensitivity symptoms; three months after treatment, there were one tooth showed a minor fracture in the restoration without affecting the appearance and function and three teeth had mildly congestive gums reaction, at the same time one tooth showed slight discoloration of the restoration; six months after treatment, one tooth showed ceramics fracture of restoration and four teeth developed mild gingivitis; twelve months after treatment, two teeth showed ceramics fracture, the edge of three restorations had slightly crack and one tooth appeared gingivitis. The periodontal conditions of the patients with gingival inflammation after treatment were improved significantly after receiving the correct oral hygiene guidance. The above defects didn't affect the aesthetics effect and the functions of restorations, and the restorations could be used normally after intraoral adjustments. Both the doctors and the patients were satisfied with the repair effects of the restorations. Conclusion: The combination of DSD and porcelain veneer in repairing anterior aesthetic teeth is good treatment plan that can achieve high patient satisfaction and ideal clinical effect.