Clinical Case
Aesthetic Rehabilitation of the Anterior Region with IPS e.max All-Ceramic Veneers
Introduction
The patient visited our clinic seeking to improve the aesthetics of her anterior teeth. The primary reason for her visit was long-term dissatisfaction with the appearance of her two upper central incisors following previous composite restorations.
After a thorough consultation and consideration of the patient’s wishes, orthodontic treatment was not included in the treatment plan. The rehabilitation therefore focused on the aesthetic restoration of the two upper central incisors using IPS e.max all-ceramic veneers.
Medical history and patient's concerns
The patient had long been concerned about the aesthetics of her anterior teeth. Both upper central incisors had older composite restorations that had become discolored over time, no longer matched the shade of the surrounding teeth, and one of the restorations showed a visible fracture.
The patient wished to achieve a natural, harmonious smile with a long-lasting and aesthetically stable result.
Clinical case
Initial clinical condition
Clinical examination revealed:
- Discoloration of older composite restorations on both upper central incisors,
- Color mismatch between the composite restorations and the adjacent teeth,
- Fracture of part of the composite restoration on one tooth,
- Sufficient healthy tooth structure suitable for minimally invasive preparation,
- Minor misalignment of the anterior teeth.
Medical history and patient's concerns
The patient had long been dissatisfied with the appearance of her anterior teeth. Both upper central incisors had older composite restorations that had become discolored over time, no longer matched the shade of the surrounding teeth, and one of the restorations showed a visible fracture.
The patient wished to achieve a natural, harmonious smile with a long-lasting, aesthetically stable result.
Diagnostics
Initial diagnostics
Before the treatment began, a comprehensive diagnostic assessment was performed, including:
Based on the clinical examination, radiographic diagnostics, digital scans, and smile aesthetics analysis, an individualized treatment plan was developed. To achieve the desired aesthetic result, it was decided to first unify the tooth shade through professional in-office whitening and then fabricate two IPS e.max all-ceramic veneers matched to the new shade of the patient’s natural teeth.
The patient was thoroughly informed about the treatment process, available options, limitations, and the expected outcome.
Treatment plan:
IPS e.max
Treatment process
Visit 1 – Initial examination
A comprehensive clinical examination was performed, including professional photographic documentation, a digital panoramic X-ray (OPG), and a digital intraoral scan of both jaws.
Based on the collected data, a digital smile analysis was carried out, evaluating tooth shape, proportions, smile line, tooth shade, and occlusion. An individualized treatment plan was then prepared.
Visit 2 – Professional tooth whitening
Professional in-office whitening of all teeth was performed using the Opalescence Boost system.
Before applying the whitening gel, the soft tissues were protected with a light-cured gingival barrier.
A whitening gel containing 40% hydrogen peroxide was then applied according to the manufacturer’s recommended clinical protocol.
The whitening procedure took approximately 2 hours.
After the treatment, the achieved tooth shade was evaluated, and the patient received instructions for the shade stabilization period.
Visit 3 – Same-day veneer fabrication
After the final tooth shade had stabilized, minimally invasive preparation of both upper central incisors was carried out.
This was followed by a digital intraoral scan of the prepared teeth using the 3Shape system and digital design of the definitive veneers.
During the same appointment, two IPS e.max lithium disilicate all-ceramic veneers were fabricated in the digital laboratory and individually matched to the new shade of the patient’s natural teeth.
After verifying the shape, contacts, translucency, aesthetics, and color match, the veneers were adhesively bonded according to the recommended cementation protocol.
The appointment concluded with an evaluation of static and dynamic occlusion, followed by final photographic documentation.
The total duration of this visit was approximately 4 hours.
IPS e.max
Treatment timeline
- Initial examination, panoramic X-ray (OPG), photographic documentation, digital intraoral scans, and treatment planning.
- Professional in-office tooth whitening using the Opalescence Boost system (approximately 2 hours).
Treatment methods used
Outcome
Following professional tooth whitening, two individually designed IPS e.max all-ceramic veneers were fabricated and shade-matched to the patient’s newly whitened natural teeth.
The discolored and aesthetically unsatisfactory composite restorations were successfully replaced, the natural anatomy of both upper central incisors was restored, and a harmonious, natural-looking smile was achieved while preserving the maximum amount of healthy tooth structure.
The result is a long-term, aesthetically stable restoration that fully met the patient’s expectations.
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