Hollywood Smile


Dr. Ghenwa El Zein

Esthetic and Implantolgy

Restorations should reproduce the physiologic behavior of the natural tooth as far as possible, with biologic, biomechanic, functional, and esthetic integration.

3 Different treatment options may be considered when esthetic adhesive restorations in the anterior region are required: direct composite restorations, ceramic laminate veneers, and metal-free crowns (lithium disilicate, zirconia, alumina).

The choice between direct and indirect techniques should be based on several criteria: tooth vitality preservation, minimum loss of sound tissue, a minimally invasive approach toward the gingival complex, esthetic demands, patient age, financial cost, and total treatment time.

Further parameters are the number and extent of involved teeth, type of function, antagonist teeth situation, feasibility of functional and anatomical recovery of the restored tooth, and biomechanical resistance of the restored tooth.

  • Direct techniques provide the maximum preservation of residual sound tissue, the restorative material must be placed and completed in one appointment. They are indicated in the following conditions: white spots (treated by means of enamel mega abrasion), class V cavities, class III and IV cavities (small, medium or large), and minor modification of color or shape.
  • Indirect techniques, on the other hand, provide remarkable advantages:
  1. Maximum esthetic result due to the high dimensional stability and color stability of ceramics.
  2. Optimal control of tooth dimension, shape, contact points, layering, finishing, and polishing.


Indirect techniques are indicated when treating multiple complex restorations, endodontically treated teeth with a major loss of sound tissue, complete crown fracture, major shape modifications, dental crowding, very young uncooperative patients, and patients with high esthetic demands,discoloration that is resistant to vital bleaching procedures; displeasing shapes or contours and/or lack of size and/or volume, requiring morphologic modifications; diastema closure; minor tooth alignment, restoring localized enamel malformations; fluorosis with enamel mottling; teeth with minor chipping and fractures; and misshapen teeth

Among indirect techniques, ceramic laminate veneers represent a well-documented, effective, and predictable treatment option.

  • What is Veneers?

In dentistry, a veneer is a thin layer of dental restorative material usually porcelain that replaces enamel.

Based on their strength, longevity, conservative nature, biocompatibility, and aesthetics, veneers have been considered one of the most viable treatment modalities.

Aesthetic veneers in ceramic materials demonstrate excellent clinical performance and, as materials and techniques have evolved, veneers have become one of the most predictable, most aesthetic, and least invasive modalities of treatment. For this reason.

  • What Veneers can do?

Porcelain veneers are an excellent solution for correcting small or medium spaces between teeth, imperfections in tooth position (e.g., slight rotations), poor color, poor shape or contours, as well as some minor occlusal (bite) related problems. Porcelain veneers can allow for dramatic improvements for patients who have worn their teeth by bruxism (grinding of one’s teeth through habit patterns) or fractured teeth.

  • The main advantages of veneers are as follows:
  1. Minimally invasive
  2. Aesthetically pleasing
  3. Durable
  4. The ability to elicit a good tissue response

Several ceramic materials are currently indicated for veneers: lithium disilicate, feldspathic ceramic, feldspathic reinforced with leucite, fluorapatite, and lithium silicate reinforced with zirconia.

Thus, translucent zirconia has been considered as an esthetic material, as it offers indications for manufacturing crowns and anterior and posterior monolithic fixed prostheses, including veneers and ultrathin veneers.

  • Emax:


E.max lithium disilicate has a wide spectrum of indications, and it is characterized by good modeling properties, high stability and excellent firing behavior. It is suitable for many types of restorations in the anterior and posterior region. Due to its natural-looking tooth coloring and excellent light-optical properties, this material produces impressive results.


  • Veneers (≥0.3 mm)
  • Inlays and onlays
  • Occlusal veneers, partial crowns
  • Minimally invasive crowns (≥1 mm)
  • Implant superstructures
  • Hybrid abutment restorations
  • 3-unit bridges up to the 2nd premolar as the terminal abutment
  • Composite:

Direct composite veneers serve as one method for restoring anterior teeth.

The reasons for choosing this treatment are: correction for esthetic concerns, attrition and erosion, abfraction, fractures, caries, diastemas, restoring proximal contact, occlusal discrepancies, the desire for a minimally invasive approach, and the financial limitations of the patient.

Also of significant benefit is their use in medically compromised patients who display dental anomalies as secondary signs of conditions such as fluorosis and amelogenesis imperfecta.

The long-term maintenance of the surface quality of materials is fundamental to improving the longevity of esthetic restorations.

The contraindications must be recognized as well. The placement of veneers is contraindicated when there is reduced interocclusal distance; deep vertical overlap anteriorly, without horizontal overlap; or severe bruxism or parafunctional activity. Severely malpositioned teeth, the presence of soft tissue disease, and teeth with extensive existing restorations are other factors that prevent the placement of laminate veneers.

  • Maintenance Of Your New Porcelain Veneers:

The maintenance of your porcelain laminate veneers is relatively simple. Here are some recommendations:

  1. Brush and floss as you normally would to prevent dental problems. Porcelain veneers are one of the kindest restorations to gum tissues that we currently have in dentistry. Don’t be afraid of damaging your laminates by either flossing or brushing. Any nonabrasive fluoride toothpaste is acceptable. A good home care regimen will ensure the esthetic success of your laminate restorations for years to come.
  1. If you are known to be a bruxer or clencher, you have a habit of grinding your teeth, please let your dentist know. He or she will fabricate a protective “occlusal” or bite guard for you to wear to minimize the stresses placed upon your teeth while you sleep.
  2. Approximately one week after the placement of your laminates you will be asked to return to the office for a treatment evaluation. This visit is extremely important. It gives your dentist the opportunity to evaluate the placement of the laminates, the gum tissue response and to answer any questions you might have regarding your new smile. Regular maintenance and dental check ups are recommended so that your veneers and oral health can be reviewed periodically.