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Operative Dentistry - Best Practices

Esthetic Buildups/Bonding

(last modified 8AUG2014)

Direct resin based composites may be used with minimal or no tooth preparation to produce more harmonious esthetics in both the anterior and posterior regions by modifying both tooth shape and shade. Appropriate treatment planning should consider the necessity of tooth whitening and occlusal function.

Advantages:

  • Conservative - mimimal or no tooth structure removal usually required
  • Economical
  • Can produce excellent esthetics
  • Good longevity

Disadvantages:

  • Can not predictably withstand heavy occlusal loading
  • Can not change emergence profile
  • Requires advanced operator training

Indications

  • Facial veneering
  • Diastemas closures
  • Tooth size discrepancies eg. peg laterals
  • Minor anterior realignment
  • Reshaping including incisal lengthening
  • Shade modification and stain removal

Relative Contraindications

  • Diastemas over two millimeters
  • Excessive overlapping of anterior teeth
  • Any restoration which does not have sufficient tooth structure for bonding support
  • Inability to achieve field control
  • Violating esthetic principles to achieve interproximal spaces closure
  • Poor tissue health
  • Should not be used to radically modify teeth