cosmetic dentistry_ beauty & science

08 I I case report _ veneers cosmeticdentistry 4_2011 then rinse them thoroughly again. Dry them with a dry air source until a chalky appearance is visible on the interior of the veneer. Ceramic primer is then applied for one minute. Dry until it is chalky again and apply another coat of ceramic primer. Leave the primer on while the teeth are etched with phosphoric acidgelfor30seconds.Rinsethoroughlyanddry the teeth and veneers until a chalky appearance shows on both. Turn the operatory light off and then apply bonding to the teeth and the veneers. Place the flowable composite onto the veneers one at a time for placement. Place all of the veneers and ensure they are correctly situated. With two hands, hold the distal two veneers (teeth #5 and 6) in place leaving a space only large enough for a curing light to shine in be- tween. Shield the rest of the veneers with your hand so that the light will not set any of the other composite except the interproximal space between veneers #5 and 6. Cure for only two seconds. Now cure the distal of veneer #5 for two seconds. Move your hands to veneers #6 and 7, shielding the rest of the veneers and holding veneer #5 and 6 in place, leave just enough room to cure the space between #5 and 6 for two seconds. Repeat the same process for the rest of the veneers, moving from #7 to 8 and so on, until all of the interproximal spaces have been cured for two seconds each, includ- ing the distal of the last veneer on the other side. Now cure the centre of each veneer for two seconds and then the lingual incisal of each for two seconds too. If cured for longer than this, it is very difficult to remove the excess composite and much time is consumed in the process. The first step in removing the excess com- posite is the use of a Bard-Parker #12 scalpel. With a palm grasp and your thumb resting on the incisal edge of a tooth, engage the flat side of the blade close to the incisal edge and push gingivally to loosen the interproximal composite. Continue until most of the composite has been loosened and removed. Use a Wedelstadt chisel in the same fashion to loosen the gingi- val composite. To break the contact, a serrated interproximal strip is used in a cross-cut sawing fashion. The Bard-Parker #12 scalpel is used again to remove more interproximal composite. Blue- tipped diamond strips are then used to remove any remaining composite and a yellow-tipped diamond strip is used to smooth. Adjust the bite, polish and you are done. Figures 1a to 5b demonstrate the good results of the technique described in this article._ Dr L.Emery Karst,a graduate of Loma Linda University’s School of Dentistry,has been practising the art of cosmetic dentistry for more than 20 years.Although he enjoys cosmetic dentistry the most,he also regularly undertakes work in endodontics,implants,crown and bridge and other techniques.Dr Karst’s articles on endodontics and cosmetic techniques have been published in DentistryToday. He also lectured on endodontics at the Oregon State Dental Convention in 2010. cosmeticdentistry _about the author Fig. 5bFig. 5a