Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Case Series
Year : 2022 | Month : June | Volume : 16 | Issue : 6 | Page : ZR01 - ZR04 Full Version

Minimally Invasive Restoration of Fractured Maxillary Central Incisors with Partial Laminate Veneers- A Case Series


Published: June 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/50840.16449
Asena Kaptanoglu, Tugce Merve Ordueri, Alaaddin Kilicaslan, Haluk Baris Kara

1. Department of Prosthodontics, Health Science Institute, Istanbul Medipol University, Istanbul, Turkey. 2. Department of Prosthodontics, Health Science Institute, Istanbul Medipol University, Istanbul, Turkey. 3. Department of Prosthodontics, Health Science Institute, Istanbul Medipol University, Istanbul, Turkey. 4. Department of Prosthodontics, Health Science Institute, Istanbul Medipol University, Istanbul, Turkey.

Correspondence Address :
Dr. Asena Kaptanoglu,
Istanbul, Turkey.
E-mail: asenakaptanoglu@hotmail.com

Abstract

Porcelain laminate veneers are one of the most preferred treatment methods today, due to the increasing interest in minimally invasive approach and their superior aesthetic properties. With the appreciation of the minimally invasive approach and the developing adhesive procedures, the partial laminate veneers have become more popular in the dental field. In this case series including three cases, the teeth were restored with partial laminate veneers by only intervening in the fractured area. In this case series, the teeth that were restored with partial laminate veneers were prepared with different techniques. Preparation was performed without bevel in enamel margin in case 1, with incisal overlap and bevel to create more natural transition on tooth surface in case 2. In case 3, preparation with incisal overlap was performed with preparation of the palatal surface of the tooth. The optical impression was made with the digital camera of the Chairside Economical Restoration of Esthetic Ceramic (CEREC) acquisition unit (Omnicam CEREC Sirona, Bensheim, Germany), in the first case. In the other cases, impression was taken with elastomeric impression materials. In addition, restorations were fabricated from feldspathic porcelain and lithium disilicate porcelain. In all the cases, restoration was cemented with resin cements. The following cases present the minimally invasive treatment of maxillary central incisors with partial laminate veneers fabricated from different ceramic materials. New materials, procedures, and techniques provide patients an improved quality of life and a greater self-esteem with creating a confident aesthetic smile.

Keywords

Aesthetic, Conservative dentistry, Minimal invasive, Partial veneer

In recent years, minimal invasive treatment modalities have become more attractive in the dental field. Conventional restorations require preparation techniques to acquire mechanical retention. On the other hand, bonded restorations do not require extensive preparations (1). Ceramic materials have high fracture resistance and colour stability. Due to these positive properties, ceramics are often preferred in clinical routine. Composite materials have excellent mechanical results too, but in comparison to ceramic restorations they have poor aesthetics (2).

Porcelain laminate veneers present improved aesthetics with minimal invasive approach. They can be indicated to correct tooth form, position, close diastemas, repair fractures or abrasions, and correct discolourations (3). In addition to their excellent aesthetic properties, porcelain laminate veneers have good biocompatibility and low fracture rates. Consequently, it brings patient satisfaction over a long period of time (1). This case series presents and discusses the minimally invasive treatment of single maxillary central incisor with porcelain partial veneer restorations.

Case Report

Case 1

A 73-year-old male patient was referred to the Department of Prosthetic Dentistry. His complaint was the unaesthetic and fractured appearance of his maxillary right incisor due to dental trauma in September, 2018 (Table/Fig 1). According to clinical and radiographic examination, the tooth was not cariously involved, had no lesions and enlarged periodontal spaces. According to dental trauma guidelines (4), the fracture was uncomplicated crown fracture which had not involved the pulp. Periodontal examination revealed that the patient’s oral health was good. The treatment alternatives which include direct composite restorations, partial laminate veneers, laminate veneers, and full crown restorations were discussed with the patient. It was decided to give partial laminate veneer treatment with ceramic materials.

The preparation was performed with chamfer shaped diamond bur (Hager & Meisinger GmbH, Neuss, Germany). Preparation was performed without bevel in enamel margin integrity in the facial surface. The incisal finish line reduction was performed with butt joint preparation design. Proximal reduction was kept just short of breaking the contact. The preparation was extended to smile line (Table/Fig 2).

After the preparation, the digital impression was taken with CEREC Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) Systems (Sirona Dental Systems GmbH, Bensheim, Germany). Tooth shade was recorded with Vita 3D-Master (3D; Vita Zahnfabrik, Bad Sackingen, Germany) and transferred to digital system.

The restoration was fabricated with lithium disilicate porcelain (Ivoclar Vivadent, Schaan, Liechtenstein). Intaglio surface of the laminate veneer was etched with 9.5% hydrofluoric (HF) acid (Ultradent) for one minute and it was washed, and dried. Silane (Monobond N, Ivoclar Vivadent, Liechtenstein) was applied to the surface with microbrush for one minute. A thin layer of bonding (Heliobond, Ivoclar Vivadent, Liechtenstein) was applied and polymerised for 20 seconds.

The etching on the tooth surface was performed with a 35% phosphoric acid solution, ultra-etch (Ultradent); the tooth was rinsed with water for 40 seconds and dried. The bonding agent (Peak Universal Bond, Ultradent) was applied for 10 seconds. The restoration was cemented with Variolink N light cure. Residual cement was removed and polymerisation was completed with application of additional 40 seconds of curing light.

The restorations were finished and polished with a no.12 surgical blade and interproximal strips. The occlusion was adjusted with laminate tungsten carbide burs, rugby-ball 40 μm diamond burs, and silicon polishers (Table/Fig 3). The patient had recall session two weeks after cementation. On 2-weeks follow-up, no changes in the restoration and cementation line were seen.

Case 2

A 32-year-old female patient was referred to the Department of Prosthetic Dentistry, with complaint of fractured maxillary central incisor (Table/Fig 4). The clinical and radiographic examination revealed that there was no caries lesion. Periodontal examination revealed that the patient’s oral health was good. The treatment alternatives which include direct composite restorations, partial laminate veneers, laminate veneers, and full crown restorations were discussed with the patient. Non invasive advantages of partial laminate veneers were presented to the patient and were chosen as the treatment option.

The preparation was performed with chamfer shaped diamond bur (Hager & Meisinger GmbH, Neuss, Germany). Chamfer finish line of 0.4 mm maximum depth were made in facial surface. 1.5 mm of incisal reduction was done with palatal chamfer design which included incisal overlap reduction to improve translucency and to provide positive seat for luting. All the internal line angles were rounded to reduce stress in the margins of the veneers. The appropriate tooth reduction was verified with the use of silicone matrix (Table/Fig 5).

After the completion of the preparation, the impression was taken via additional type elastomeric impression material (Elite H-D, Zhermack, Germany). The restoration was fabricated with feldspathic porcelain (Ivoclar Vivadent, Schaan, Liechtenstein). Intaglio surface of the laminate veneer was etched with 9.5% HF acid (Ultradent) for 20 seconds, washed, and dried. Silane (Monobond N, Ivoclar Vivadent, Liechtenstein) was applied to the surface with microbrush and waited for one minute. A thin layer of bonding (Heliobond, Ivoclar Vivadent, Liechtenstein) was applied and polymerised for 20 seconds.

The etching on the tooth surface was performed with a 35% phosphoric acid solution, ultra-etch (Ultradent); the tooth was rinsed with water for 40 seconds and dried. The bonding agent (Peak Universal Bond, Ultradent) was applied for 10 seconds. The restoration was cemented with Variolink N light cure. Residual cement was removed and polymerisation was completed with application of additional 40 seconds of curing light.

The restorations were finished and polished with a no. 12 surgical blade and interproximal strips. The occlusion was adjusted with laminate tungsten carbide burs, rugby-ball 40 μm diamond burs, and silicon polishers (Table/Fig 6). The patient had recall session two weeks after cementation. At 2-weeks follow-up, no changes in the restoration and cementation line were noted.

Case 3

A 21-year-old male was referred to Department of Prosthetic Dentistry. The main complaint of the patient was the white spotted and flecked appearance of the central incisor tooth (Table/Fig 7). This was because the patient had dental fluorosis. Two main sources of fluoride that likely lead to the increased occurrence of dental fluorosis are greater than 1 ppm in drinking water and dental products containing fluoride (e.g., toothpastes and mouthrinses if swallowed or fluoride supplements) (5). The clinical and radiographic examination revealed that there was no caries lesion. Periodontal examination revealed that the patient’s oral health was good. The treatment alternatives, which include direct composite restorations, partial laminate veneers, laminate veneers, and full crown restorations, were discussed with the patient. It was decided to give partial laminate veneer treatment with ceramic materials.

The preparation was performed with chamfer shaped diamond bur (Hager & Meisinger GmbH, Neuss, Germany). Chamfer finish line of 0.4 mm maximum depth were made in facial surface. Incisal reduction was done with incisal overlap to improve translucency and to provide positive seat for luting. All the internal line angles were rounded to reduce stresses in the margins of the veneers. The appropriate tooth reduction was verified with the use of silicone matrix (Table/Fig 8).

The restoration was fabricated with lithium disilicate porcelain (Ivoclar Vivadent, Schaan, Liechtenstein). Intaglio surface of the laminate veneer was etched with 9.5% HF acid (Ultradent) for 20 seconds, washed, and dried. Silane (Monobond N, Ivoclar Vivadent, Liechtenstein) was applied to the surface with microbrush and waited for one minute. A thin layer of bonding (Heliobond, Ivoclar Vivadent, Liechtenstein) was applied and polymerised for 20 seconds.

The etching on the tooth surface was performed with a 35% phosphoric acid solution, ultra-etch (Ultradent); the tooth was rinsed with water for 40 seconds and dried. The bonding agent (Peak Universal Bond, Ultradent) was applied for 10 seconds. The restoration was cemented with Variolink N light cure. Residual cement was removed and polymerisation was completed with application of additional 40 seconds of curing light.

The restorations were finished and polished with a no.12 surgical blade and interproximal strips. The occlusion was adjusted with laminate tungsten carbide burs, rugby-ball 40 μm diamond burs, and silicon polishers (Table/Fig 9). The patient had recall session two weeks after cementation. The restored teeth was healthy at 2-weeks follow-up.

Discussion

The complaints of all the patients were same. Following different treatment plans were created for the patients requesting to have aesthetic smile with a minimal invasive treatment, a) Filling with a composite resin; b) Restoration with partial laminate veneers; c) Restoration with laminate veneer; d) Restoration with crown. The treatment options, which were restoring the tooth with conventional laminate veneer or crown were abandoned due to the need for more preparation of healthy structure of enamel (3). The filling with composite resin would meet the short-term (instant) expectation of the patients, but it was not preferred due to the disadvantages such as short-term colour stability of the composite resins, loss of brightness due to low resistance to abrasion and the increase in the plaque accumulation due to the deterioration of the surface texture (6),(7),(8).

According to a study by Farias-Neto A et al., 180 samples of veneers (direct and indirect resin and porcelain) were cemented on anterior teeth, and after 2 years, the most satisfying treatment option was porcelain laminate veneers (9). The minimal invasive treatments such as partial laminate veneers should be considered as the first treatment option as they allow preservation of dental tissue while providing highly satisfactory aesthetic results (9). Laminate veneers are one of the minimal invasive treatment options. In the laminate veneer preparation, more enamel tissue is reducted compared to the partial laminate veneer preparation. In addition, preparation for crown restoration is not one of the minimal invasive treatment options. Therefore, in this case series, crown restoration was not suggested as a treatment option (1).

Feldspathic ceramics and lithium disilicate are two of the most used indirect restorative materials (10). Lithium disilicate ceramics, besides the functional and aesthetic characteristics, have benefits such as greater fracture resistance when compared to feldspathic ceramics, providing their clinical longevity. In case 1, the lithium disilicate material was preferred, due to the patient’s parafunctional habit, such as bruxism (11),(12). In addition, feldspathic ceramics are a good treatment option due to their biocompatibility with adjacent tissue, excellent aesthetics, high translucency, and colour stability. In case 2, the feldspathic ceramic material was preferred, due to its high translucency (13),(14). These two materials have wide colour variety, ability to mimic translucency and dental fluorescence, colour and brightness stability (15),(16).

The results of an in-vitro study showed that increasing the IPS Empress porcelain thickness from 0.5 to 1.5 mm had no adverse effect on the light-cure and dual-cure resin cements. Thus, these cements can be used as luting agents for porcelain veneers with upto 1.5 mm thickness (17).

Besides, avoiding the need for anaesthesia and using the retraction cords for partial laminate veneers preparation is an advantage as it reduces the working time. Also, the necessary working time for positioning the restorations and removing the excess cement was conveniently shortened at the discretion of the clinician (2).

On the other hand, the cementation line between the dental structure and restoration may be visible. It is still discussed in the dental literature that the biggest downside of partial laminate veneer treatment is that the border may be unaesthetic. Therefore, partial laminate veneers can be one of the treatment options for the elderly who have been reported to present a low smile line, hence, preventing this border from being visible. Thanks to the considerable improvement of the aesthetic properties of the materials up-to-date, it allows to eliminate the disadvantage of unaesthetic appearance of cementation line in young patients who have high smile line (18).

Conclusion

In these case presentations, the fractured half of maxillary central incisors were restored with porcelain laminate veneer restorations. Despite the aesthetic limitations of horizontal finish line in the middle of the clinical crown, the successful results can be achieved with the application of up-to-date highly aesthetic materials by experienced clinicians. This type of restoration can be used as an alternative to direct composite, laminate veneer, and full crown restorations in the anterior area for the restoration of a limited defect.

References

1.
Horvath S, Schulz CP. Minimally invasive restoration of a maxillary central incisor with a partial veneer. Eur J Aesthet Dent. 2012;7(1):06-16.
2.
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DOI and Others

DOI: 10.7860/JCDR/2022/50840.16449

Date of Submission: Jun 12, 2021
Date of Peer Review: Aug 24, 2021
Date of Acceptance: Feb 07, 2022
Date of Publishing: Jun 01, 2022

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jun 18, 2021
• Manual Googling: Feb 05, 2022
• iThenticate Software: Mar 12, 2022 (17%)

ETYMOLOGY: Author Origin

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