cosmetic dentistry_beauty & science No. 1, 2017

| case report aesthetic and restorative dentistry Figs. 2o-q: Smile and occlusal views of this full-mouth rehabilitation, using only direct restorations. Such an approach is highly conservative, comfortable for the patient owing to the short treatment time, and cost-effective. Fig. 2o Fig. 2p Fig. 2q Direct composite option composite restoration are its highly conservative approach, the ability to replace or reshape small portions of the tooth, reparability, simplified replace­ ment and relatively limited cost (Fig. 2). Conversely, it is more technique sensitive and might result in thin layers of material over some surfaces, placing them mechanically at risk. When using a sculpting technique, proper anatomy can be created also with a direct technique, favouring the selection of a highly filled material with a firm consistency.27­29 In the case illustrating this treatment modality, a high­ ly filled homogenous nanohybrid material (inspiro, Edelweiss DR) was used owing to its firm consistency, favourable for free­hand sculpting and modelling (Figs. 2f­l). Indirect composite option The indirect option is logically preferred when larger restorations or tissue destruction of a greater severity is present. It also provides greater control of the anat­ omy and occlusion in complex or advanced cases. Nevertheless, one should not neglect the direct op­ tion only in favour of this last parameter, as occlusion seems not to play a major role in the origin of para­ function.4, 5, 30­32 Since direct and indirect techniques can be used together to treat the same patient, when indirect restorations are chosen, they have to be fab­ ricated first, at the new VDO, and then direct compos­ ites placed. Material selection The direct composite option is logically indicated for all forms of moderate to intermediate tissue loss or destruction.13­16 Among the benefits of a direct Today, the debate about whether ceramics or com­ posite is best indicated for such restorations is some­ 30 cosmetic dentistry 1 2017

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