See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/26765039

Esthetic rehabilitation of anterior conoid teeth: comprehensive approach for

improved and predictable results

Article  in  European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry, The · February 2009
Source: PubMed

CITATIONS READS

14 1,432

6 authors, including:

Jose Augusto Rodrigues Andre Reis

Universidade Guarulhos Universidade Guarulhos
111 PUBLICATIONS   1,294 CITATIONS    82 PUBLICATIONS   1,692 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Dental research View project

Implant Macro- and Mirco-design: Performance in vitro and in vivo View project

All content following this page was uploaded by Andre Reis on 25 March 2015.

The user has requested enhancement of the downloaded file.

 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
Esthetic Rehabilitation of Anterior sse nc e fo r

Conoid Teeth: Comprehensive

Approach for Improved and
Predictable Results
Carlos E. Pena, DDS, MS
Department of Operative Dentistry, Guarulhos University,
R. Dr. Nilo Peçanha 81, Guarulhos, SP, 07011-040, Brazil

Ronaldo G. Viotti, DDS, MS

Department of Operative Dentistry, Guarulhos University,
R. Dr. Nilo Peçanha 81, Guarulhos, SP, 07011-040, Brazil
and Blumenau Regional University, Blumenau, SC, Brazil

Walter R. Dias, DDS, MS

Dental Research Manager, Dentsply DeTrey GmbH,
De-Trey-Str. 1, 78467, Konstanz, Germany

Edward Santucci, DDS, MS

Director of Clinical Research, Dentsply Caulk, 38 W Clarke Ave,
Milford, DE, 19963, USA

Jose A. Rodrigues, DDS, MS, PhD

Assistant Professor, Department of Operative Dentistry, Guarulhos University,
R. Dr. Nilo Peçanha 81, Guarulhos, SP, 07011-040, Brazil

Andre F. Reis, DDS, MS, PhD

Assistant Professor, Department of Operative Dentistry, Guarulhos University,
R. Dr. Nilo Peçanha 81, Guarulhos, SP, 07011-040, Brazil

Correspondence to: Dr. Andre F Reis

Department of Operative Dentistry, Guarulhos University, Rua Dr. Nilo Peçanha 81, Predio U, 6o. Andar,
Guarulhos, SP, Brazil, 07011-040, Phone: +55 11 6464-1769 Fax: +55 11 6464-1758, e-mail: areis@prof.ung.br

210
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n
ot

Abstract
The esthetic success of a dental treatment
depends on the correct diagnosis, treat-
ment plan and clinical and laboratory pro-
cedures. This clinical report describes a
diagnostically based protocol for conser-
vative preparations on anterior teeth for ad-
hesively retained composite and porcelain
restorations. The diagnostic additive wax-
up, periodontal esthetic crown-lengthen-
ing, direct acrylic mock-up, conservative
preparations for ceramic laminate veneers,
luting procedures, direct restorations with
n
ss e n c e
fo r
composite resin used for the esthetic reha-
bilitation of a patient presenting conoid lat-
eral incisors, and an unsatisfactory class IV
restoration in the left central incisor are
presented. An accurate diagnostic and in-
terdisciplinary approach is necessary for
obtaining improved, conservative and pre-
dictable esthetic results in esthetically
compromised areas, such as the anterior
maxillary dentition.
(Eur J Esthet Dent 2009;4:210–224.)

211
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
tio
te ot n

n
Introduction ss e n c e
fo r
The increasing demands of patients and
clinicians regarding esthetic restorations,
together with the improvements in adhe-
sive materials, composite resins and den-
tal porcelains have brought the possibility
of conservative long-lasting esthetic treat-
ments.1 Due to their lifelike appearance,
porcelain laminate veneers are often se-
lected for the esthetic restoration of the an-
terior dentition. The use of laminate ve-
neers and composite resins has matured
to a predictable treatment method in terms
of longevity, periodontal status and patient
satisfaction.2,3
Porcelain laminate veneers and com-
posite restorations offer a predictable op-
tion for creating a successful restorative
treatment that also preserves maximum
tooth structure.3-5 For conservative veneer
preparations, two essential tools are re-
quired during diagnostic steps and tooth
preparation procedures: the additive diag-
nostic waxup and the acrylic mock-up.6
When there is no need for color masking,
a minimal reduction of tooth structure al-
lows the translucency of the veneer to ren-
der a natural appearance. Furthermore, an
ultraconservative preparation preserves
the available enamel for bonding, thus in-
creasing the prognosis for long-term bond-
ing success.7
Factors contributing to the composition
of a pleasant smile, such as amount of gin-
gival display, gingival architecture, clinical
crown dimensions and tooth position play
an important role in the esthetic value of a
cosmetic restoration.8,9 In such cases, an in-
terdisciplinary approach is necessary to
Figs 1 and 2 Preoperative views of patient’s face
evaluate, diagnose, and resolve esthetic
and smile.
problems using a combination of ortho-
dontic, periodontal and prosthodontic treat-

212
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
ments. The aim of this clinical report is to ss e n c e fo r
describe a diagnostically based protocol
for conservative anterior teeth preparations
for adhesively retained composite and
porcelain restorations. In addition, this pro-
tocol is associated with an esthetic gingival
plastic surgery for maximal esthetic effect.

Case report
A 22-year-old female patient was initially
seen at the Graduate Operative Dentistry
clinic of the Guarulhos University School of
Dentistry with the chief complaint of ‘poor
dental esthetics’ especially due to conoid
lateral incisors. Relevant dental history in-
cluded previous orthodontic treatment. Be-
sides presenting with conoid lateral inci-
sors, the gingival contour of both teeth was
approximately 3 mm coronal to the zeniths
of the canines and central incisors. Thus,
before embarking upon the prosthetic
treatment, the ideal harmony in this specif-
ic region should be restored.9 Her left cen-
tral incisor presented an unsatisfactory
Class IV composite restoration, whereas
the right central incisor, although unre-
stored, presented an inverted incisal edge.
The right canine showed white spots, and
the left canine presented a small but discol-
ored composite restoration on the buccal
surface.
After the patient had expressed her
treatment expectations, clinical and radi-
ographic examinations were performed. In
addition, photographs (Figs 1 to 5) and
stone casts were obtained to complete the
initial documentation. Based on the exam-
inations and diagnostic tools, the existing
Figs 3 to 5 Preliminary intra-oral view of maxillary
problems and major elements of the treat-
anterior teeth. The patient presented lateral conoids, un-
ment were explained to the patient. The se- satisfactory composite restorations and the central in-
quence of treatment planning consisted of cisors showed inverted incisal edges.

213
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
Table 1 List of materials, procedures and manufacturer’s for the product used.
ss e n c e fo r
Product Procedure Manufacturer

#15c surgical blade Gingivectomy BD Bard-Parker, Franklin Lakes, NJ USA

10% carbamide peroxide Bleaching FGM, Joinvile, SC, Brazil

High Viscosity C-Silicone, Zetaplus Silicon index Zhermack, Badia Polesine, RO, Italy

Self-cure methacrylate resin, Mock-up and Dentsply Caulk, Milford, DE, USA
Integrity provisionals

Diamond burs Preparation KG Sorensen, São Paulo, SP, Brazil

Ultrapak deflection cord Gingival deflection Ultradent Products Inc., South Jordan, UT, USA

Aquasil Ultra Heavy and XLV (Digit) Impression Dentsply Caulk, Milford, DE, USA

Calibra Resin Cement Luting Dentsply Caulk, Milford, DE, USA

IPS Empress Esthetic, Laminate venners Ivoclar-vivadent, Schaan, Liechtenstein

leucite glass ceramic

XP Bond, two-step etch&rinse adhesive Bonding Dentsply Caulk, Milford, DE, USA

Teflon tape Isolating Tigre S.A., Joinville, SC, Brazil

SmartLite IQ2 LED curing unit Light curing Dentsply Caulk, Milford, DE, USA

Esthet-X Micro Matrix Restorative Restorations Dentsply Caulk, Milford, DE, USA

Enhance/Pogo Finishing and Dentsply Caulk, Milford, DE, USA

polishing

Astropol rubber polisher polishing Ivoclar-Vivadent, Schaan, Liechtenstein

Enamelize diamond paste polishing Cosmedent, Chicago, IL, USA

plastic periodontal surgery to optimize the
gingival contour, bleaching with the night-
guard vital bleaching technique, diagnos-
tic wax-up, acrylic mock-up, laminate ve-
neers for the lateral incisors and composite
restorations for the central incisors and ca-
nines. The list of materials and manufactur-
ers’ is presented in Table 1.
Figures 6 to 11 demonstrate the se-
quence of the esthetic crown-lengthening
procedure. According to probing depths
(Figs 6 and 7) the gingival margin covered
approximately 4 mm of the crown of the lat-
eral incisors, thus no osseous tissue re-
moval was necessary to establish a pleas-
ant gingival contour and rearrange zenith
positions. The heights of the lateral incisors
are generally 1 mm shorter at the gingival
margin than are the central incisors.10,11 Soft
tissue was removed from the lateral inci-
sors and right canine.
After healing of the gingival tissue,
casts of the teeth with the new gingival
contour were performed. One set of casts
were used for fabricating a soft tray for the
nightguard vital bleaching technique with
10% carbamide peroxide, and the other
set of casts were sent, together with the
initial photographs to the laboratory tech-
nician who produced the diagnostic wax-
up (Figs 12 and 13), with which a silicon in-
dex (Fig 14) was used to fabricate a mock-up
directly in the patient’s mouth. This was
done using an auto-mix self-cured metha-
crylate resin (Integrity) (Fig 15). Before ap-
plying the resin for the mock-up, the teeth
were isolated with petroleum jelly. The ex-
cess resin was trimmed with a no. 12 sur-

214
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n
ot

n
ss e n c e
fo r

Figs 6 to 11 Sequence of the esthetic crown-lengthening procedure.

215
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
tio
te ot n

n
ss e n c e
fo r

Figs 12 and 13 Initial stone casts and diagnostic wax-up.

Fig 14 Silicon index. Fig 15 The silicon index was used to fabricate a
mock-up using a self-cured methacrylate resin

gical blade (Fig 16) and the final luster was

obtained with a light-cured resin material
(Lasting Touch, Dentsply Caulk). Minor de-
fects and irregularities of neighboring
teeth were also revealed by the mock-up.
Figures 17 to 19 shows the acrylic
mock-up, which was approved by the pa-
tient. The patient subsequently used this
mock-up for several days to evaluate if the
planned restorative procedures were com-
patible with her personality, face, smile, oral
Fig 16 The excess resin was trimmed with a no. 12 functions and subjective expectations.6,10
blade.

216
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
ss e n c e fo r

For preparation of the lateral incisors, a sim-

plified technique for porcelain laminates
driven by the diagnostic mock-up de-
scribed by Magne & Belser was used.12
The advantages of this technique com-
pared with tooth-preparation techniques
based on the existing tooth surface are:
time efficiency, enamel preservation, sub-
sequent improvement of adhesion and
mechanics, and respect of the pulp. The
recommended thicknesses for porcelain
veneers are less than 0.5 mm in the cervi-
cal area, 0.7 mm in the middle and incisal
thirds, and greater than 1.5 mm incisal cov-
erage.6,10,12 To accurately achieve these di-
mensions, the tooth provisionally restored
by the acrylic mock-up was prepared us-
ing round calibration diamond burs guid-
ed by the template itself (Fig 20). Two round
diamond burs were used in this step: no.
1014 (Ø 1.4mm) and no. 1016 (Ø 1.8 mm),
(KG Sorensen) to act as differential depth
cutters. The larger bur is used between the
middle and incisal thirds to produce a
groove of approximately 0.7 mm, and the
small round bur is used to create a groove
Figs 17 to 19 The clinical situation of the mock-up
of 0.5 mm between the cervical and middle and its effect on the patient’s smile and face is shown
thirds. This technique is very conservative in Figs 17 to 19.

217
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
ti
te incisors, on
ot

n
Figs 20 to 26 For preparation of the lateral
ss e nbyc e
fo r
a simplified technique for porcelain laminates driven
the diagnostic mock-up was used. Two round diamond
burs were used in this step to act as differential depth
cutters.

Fig 21 The grooves were then marked with a pencil. Fig 22 The remnants of the mock-up were removed
with a scaler.

Figs 23 and 24 Tapered round-ended diamond burs were used for removal of excess tooth structure.

218
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

and most of the enamel should be pre-
served. The grooves were then marked with
a pencil (Fig 21) and the remnants of the
mock-up were removed with a scaler
(Fig 22). Tapered round-ended diamond
burs were used for removal of excess tooth
structure. Sufficient tooth reduction was ob-
tained when the pencil marks disappeared
(Figs 23 and 24). The need for incisal re-
duction can be accurately checked with the
silicon palatal index (Fig 25). The final tooth
preparation can be observed in Figure 26.
n
The impression was made using a polyvinyl
ss e n c e fo r
siloxane material (Aquasil Ultra Heavy and
XLV Digit, Dentsply Caulk, Milford, DE, USA).
The one-step/double-mix impression in
conjunction with a double cord gingival dis-
placement technique was used (Fig 27).13,14
The impression was sent to the lab techni-
cian together with the photographs ob-
tained from the mock-up. Provisional
restorations were prepared using the same
silicon index that was used for fabricating
the mock-up.

Fig 25 The need for incisal reduction was checked Fig 26 The final tooth preparation is shown.
with the silicon palatal index.

Fig 27 The impression was made using a polyvinyl Fig 28 Intra-oral view of preparation of the lateral in-
siloxane material. The one-step/double-mix impression cisors prior to luting procedures.
in conjunction with a double cord gingival displace-
ment technique was used.

219
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT
Figure 28 shows the preparation of the lat-
eral incisors prior to luting procedures. The
porcelain laminate veneers were made of
a leucite-reinforced ceramic (IPS Empress
Esthetic, Ivoclar-vivadent, Schaan, Liech-
tenstein) (Fig 29). Veneers were first
checked for seating and marginal fit on
their original stone die and then on the
tooth preparations. Laminate veneers were
luted with a light-cured resin cement sys-
tem (Calibra, Dentsply) in order to bond
the ceramic restoration to the tooth struc-
ture. The adequate shade for the resin ce-
ment was confirmed by using the try-in
paste and the light shade was selected. Af-
ter try-in procedures, the internal surfaces
of the veneer were thoroughly rinsed with
a water spray and air-dried. In order to ob-
tain an effective bonding to the leucite-
based ceramic a combination of microme-
chanical interlocking produced by etching
with 10% hydrofluoric acid for 60 seconds
and chemical coupling with a silane (Cali-
15
bra Silane Coupling Agent) was used. Af-
ter rinsing the etchant, and prior to applying
the silane, the veneers were placed in a
95% alcohol ultrasonic bath for 4 minutes.
After the internal surfaces of the ceram-
ic veneers were prepared, the teeth were
bonded for receiving the ceramic restora-
tions. Deflection chords (Ultrapak #000)
were used to isolate the preparations. A
two-step etch-and-rinse adhesive system
was used (XP Bond, Dentsply). The prepa-
ration was etched with 34% phosphoric
acid for 15 s (Fig 30), thoroughly rinsed
with water for 15 s and air-dried. The dry
bonding technique was used because the
conservative preparation was limited to
enamel. In order to protect the adjacent
teeth from being unnecessarily etched and
prevent accumulation of excess resin ce-
ment in the interproximal area, they were
220
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
pyrig
No Co
ht
t fo
rP
by N
ub
Q ui
lica
tio
te ot n
n
protected with teflon tape. The adhesive
ss e n c e
fo r
system was applied (Fig 31) and a gentle
air stream was used to evaporate the sol-
vent and air thin the adhesive. A coat of ad-
hesive resin was also applied to the ve-
neers. It was air thinned but not light cured,
to avoid problems with marginal fit. The
resin cement was dispensed directly onto
the veneer and the restoration was seated
slowly. Excess was removed with a micro-
brush prior to light curing for 60 s with an
LED (SmartLite IQ2, Dentsply) from the
buccal surface, followed by another 60 s
from the palatal surface. Polymerized ex-
cess resin cement was removed with a
No.12 surgical blade (Fig 32). Final polish-
ing of the margins was performed with sil-
icon dioxide rubber polishers (Astropol,
Ivoclar-Vivadent).
In the following session, the central inci-
sors were restored with a microhybrid
resin composite (Esthet-X, Dentsply). A sil-
icon index was obtained from the working
model after the central incisors were
waxed-up and with the ceramic veneers in
place (a procedure that was performed
prior to the final cementation of the ve-
neers). This palatal index guided the
palatal and incisal shape of the restoration
(Fig 33). After etching enamel for 15 s, the
single bottle XP Bond adhesive system
was applied and light-cured for 10 s. The
first composite resin increment (shade Y-
E) was inserted with the aid of the silicon
index and light-cured for 20 s (Fig 34). The
second composite increment was formed
using an opaque resin (shade W-O) in an
attempt to mask the dark background and
simulate dentin mamelons (Fig 35). The
incisal edge was formed using shade W-
E (Fig 36) and the final increment to simu-
late enamel was placed using shade A1
resin composite (Fig 37). The restoration
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
ss e n c e fo r

Fig 29 Porcelain laminate veneers were made of a Fig 30 The preparation was etched with 34% phos-
leucite-reinforced ceramic. phoric acid for 15 s thoroughly rinsed with water for 15 s
and air-dried.

Fig 31 The adhesive system was applied and a gen- Fig 32 Polymerized excess resin cement was re-
tle air stream was used to evaporate the solvent and air moved with a No.12 surgical blade.
thin the adhesive.

Fig 33 A silicon index guided the palatal and incisal Fig 34 The first composite resin increment was in-
shape of the restoration. serted with the aid of the silicon index and light-cured
for 20 s.

221
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT pyrig
No Co

ht
t fo
rP

by N
ub

Q ui
lica
tio
te otn

n
ss e n c e
fo r

Fig 35 The second composite increment was Fig 36 The incisal edge was formed.
formed using an opaque resin in an attempt to mask
the dark background and simulate dentin mamelons.

Fig 37 The final increment to simulate enamel was Fig 38 The restoration prior to polishing is shown.
placed using shade A1 resin composite.

Fig 39 Finishing was performed with extra fine dia- Fig 40 The final composite restorations, together with
mond burs. Initial polishing was accomplished with the ceramic laminate veneers can be observed.
rubber cups, and the final luster was obtained with a di-
amond polishing paste.

222
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 PENA ET ALopyrig
No C

ht
t fo
rP

by N
ub

Q ui
lica
tio
te n ot

n
ss e n c efo r

Figs 41 to 43 The integration of the esthetic restora-

tive treatment with the patient’s lips is shown.

prior to polishing is shown on Figure 38.

Finishing was performed with extra fine di-
amond burs. Initial polishing was accom-
plished with rubber cups (Enhance Pogo,
Dentsply), and the final luster was obtained
with a diamond polishing paste (Enam-
elize, Cosmedent, Chicago, IL, USA)
(Fig 39). The white spot on the right canine
was also restored and the composite
restoration that existed on the buccal sur-
face of the left canine was replaced.
Fig 44 The final composite restorations, together with
the ceramic laminate veneers can be observed.

223
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
 CASE REPORT
The final composite restorations, together
with the ceramic laminate veneers can be
observed in Fig 40. The integration of the
esthetic restorative treatment with the pa-
tient’s lips is shown in Figures 41 to 43. The
pleasant smile, as seen in figure 44 shows
the success of this esthetic treatment.
Conclusion
The present report describes an interdisci-
plinary approach for obtaining an excellent
final esthetic and functional result. Predict-
ing the treatment outcome is essential
when planning a substantial esthetic reha-
bilitation. The diagnostic steps were ex-
tremely important tools for the ultraconser-
vative laminate preparations and for the
satisfaction of the patient.
Acknowledgements
The authors give special thanks to Mr. José Carlos Ro-
manini for the excellent work on the ceramic laminate
veneers.
224
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 4 • NUMBER 3 • AUTUMN 2009
View publication stats
pyrig
No Co
ht
t fo
rP
by N
ub
Q ui
lica
tio
te ot n
n
References ss e n c e
fo r
1. Magne P, Magne M. Treatment of extended ante-
rior crown fractures using Type IIIA bonded
porcelain restorations. J Calif Dent Assoc
2005;33:387–396
2. Peumans M, De Munck J, Fieuws S, Lambrechts
P, Vanherle G, Van Meerbeek B. A prospective
ten-year clinical trial of porcelain veneers. J
Adhes Dent 2004;6:65–76
3. Magne P. Composite resins and bonded porce-
lain: the postamalgam era? J Calif Dent Assoc
2006;34:135–147.
4. Kois JC, McGowan S. Diagnostically generated
anterior tooth preparation for adhesively retained
porcelain restorations: rationale and technique. J
Calif Dent Assoc 2004;32:161–166.
5. Edelhoff D, Sorensen JA. Tooth structure removal
associated with various preparation designs for
posterior teeth. Int J Periodontics Restorative Dent
2002;22:241–249.
6. Magne P, Magne M. Use of additive waxup and
direct intraoral mock-up for enamel preservation
with porcelain laminate veneers. Eur J Esthet
Dent 2006;1:10–19.
7. Rouse J, McGowan S. Restoration of the anterior
maxilla with ultraconservative veneers: clinical
and laboratory considerations. Pract Periodontics
Aesthet Dent 1999;11:333–339.
8. Claman L, Alfaro MA, Mercado A. An interdiscipli-
nary approach for improved esthetic results in the
anterior maxilla. J Prosthet Dent 2003;89:1–5.
9. Fradeani M. Esthetic rehabilitation in fixed
prosthodontics. Volume 1: Esthetic analysis.
Chicago: Quintessence; 2004;352.
10. Magne P, Belser U. Bonded porcelain restorations
in the anterior dentition: a biomimetic approach.
Chicago: Quintessence; 2002.
11. Reddy MS. Achieving gingival esthetics. J Am
Dent Assoc 2003;134:295–304.
12. Magne P, Belser UC. Novel porcelain laminate
preparation approach driven by a diagnostic
mock-up. J Esthet Restor Dent 2004;16:7–16.
13. Perakis N, Belser UC, Magne P. Final impres-
sions: a review of material properties and
description of a current technique. Int J Periodon-
tics Restorative Dent 2004;24:109–117.
14. Cloyd S, Puri S. Using the double-cord packing
technique of tissue retraction for making crown
impressions. Dent Today 1999;18:54–59.
15. Soares CJ, Soares PV, Pereira JC, Fonseca RB.
Surface treatment protocols in the cementation
process of ceramic and laboratory-processed
composite restorations: a literature review. J
Esthet Restor Dent 2005;17:224–235.