Introduction to the case

1. Name: Patrick Angelo S. Lim Professor: Dr. Maricar Joy Andres University: Centro Escolar University, Manila, Philippines Foto Sign/Logo of University Dental Enamel is primarily composed of Hydroxyappatite, which is insoluble in neutral to alkaline environment. Solubility or demineralization increases as the oral pH becomes more acidic. For patients suffering with Gastroesophageal Reflux Disease (GERD) where there is a reflux of hydrochloric acid from the stomach, hydroxyapatite becomes demineralized, which is the early step of dental erosion. Direct Full Veneer has been the restoration of choice primarily to protect the exposed dentin and to establish an esthetically pleasing dentition. Such procedure however imposes a great challenge due to the sensitivity of the technique and materials to be used. Selecting composites that possess adequate strength and lifelike optical properties is one important factor operator must consider to come up with restoration that is functionally sound and esthetically pleasing. Before After Introduction to the case This photo presents dental erosion on patient suffering from GERD. Observe dentin exposure on affected teeth. Direct Full Veneer Restoration using Ceram X ® duo. Step 1. Shade Selection Step 2. Debridement Step 4. Isolation Step 3. Etching 34% Tooth Conditioner Gel was used to etch the enamel portion of the teeth. It was left undisturbed for 30 seconds and then washed with water. Etched surfaces were cotton damp dried to avoid dehydration of tooth tissue. Teeth to be restored are isolated using cotton roll to provide acceptable moisture control for the procedure. Shade selection was done under natural light using the Ceram X® duo shade fingers. D3 was selected as the appropriate shade. There has been much tooth tissue loss due to GERD. Thus, debridement was opted using pumice and rubber cup to prepare the tooth on receiving restorative material. Step 5. Priming and Bonding Step 6. Filling and Packing Step 6.b. Filling and Packing Step 8. Contouring, Finishing and Polishing Prime&Bond NT was applied evenly using applicator tip and was dried with compressed air to let the solvent evaporate. It was then light cured for 20 seconds. Ceram X dentin duo D3 was applied in increments at the dentin area using composite applicator. Each increment was cured for 40 seconds. Unfilled areas were filled with Ceram X enamel duo E3. Each increment was cured for 20 seconds. Proximal areas were restored holding a hand instrument against the celluloid strip to avoid overhanging restoration. Restoration was contoured, finished and polished using the Enhance® Finishing System with a low speed handpiece. Material and method The procedure was carried out using Ceram X® duo Restorative System and the Enhance® Finishing System following its enclosed directives. The system is true to its promise of providing natural esthetics with simplicity of procedure and excellent handling characteristics. Discussion and conclusion Nature’s estethic demand is truly high and Restorative systems nowadays must meet this estethic demand without sacrificing the simplicity of the procedure, excellence in terms of handling characteristics, and longevity of the restoration. With this, more than the natural esthetics it can provide, operators must consider a lot more factors when it comes to choosing a restorative system beneficial to the patient and the operator.