How successful can discolored teeth be esthetically restored with monolithic restorative materials

A case report

Abstract

The discoloration of enamel and dentin often has a lasting negative impact on the esthetic appearance. The current clinical case report illustrates which results can be achieved by supply- ing a patient with restorations fabricated from translucent tooth-colored materials for a traumatically damaged and discolored anterior tooth. A 20-year-old patient sought dental care due to a severe discrepancy in color and shape of tooth 11. As internal bleaching did not reveal a satisfying esthetic outcome, consequently we decided to supply the tooth with a 360° veneer. For material comparisons, the restorations were fabricated from five different monolithic materials. The preparation was performed following the guidelines for 360° veneers, featuring a circular thickness of 0.9 mm. The selected materials included indirect resin composite (Grandio blocs LT, VOCO), feldspathic ceramic (VITABLOCS Mark II LT, VITA Zahnfabrik), leucite-reinforced glass ceramic (IPS Empress CAD LT, Ivoclar Vivadent), lithium disilicate ceramic (IPS e.max CAD LT, Ivoclar Vivadent), and zirconia with 5 mol% yttrium oxide (VITA YZ XT Multicolor LT, VITA Zahnfabrik). The materials were compared for the parameters profitability, esthetics, and patient satisfaction. With a thin layer thickness (0.8–0.9 mm circular), the tooth discoloration could not be adequately covered by any of the 360° veneers. After more extensive preparation, providing a circular thickness of the restoration up to 1.5 mm, all five monolithic materials as well as an additional individually veneered zirconium dioxide crown, serving as a reference, could achieve a satisfactory result. However, the overall esthetic appearance was completely rounded off by the individualized zirconium dioxide crown.