SUMMARY Objectives: The case report describes a minimally invasive, multidisciplinary approach to a single discolored anterior tooth, with internal bleaching using traditional Japanese paper (Washi), a gingivoplasty with a three-dimensional (3D) printed surgical guide, and ultrathin feldspathic porcelain veneers. Clinical consideration: The patient’s primary concern was improving her smile. After clinical evaluation, internal tooth bleaching for the discolored tooth and gingivoplasty with restoration of the maxillary anterior six teeth and first premolars was recommended. The internal tooth whitening was accomplished with sodium perborate mixed with 30% hydrogen peroxide impregnated in Washi and sealed in the root canal with glass ionomer. Once the tooth bleaching was completed, the 3D printed surgical guide was placed in the patient’s maxillary anterior region and used to guide soft tissue recontouring. After 6 months, ultrathin feldspathic porcelain veneers were placed. Conclusion: Well-planned restorative procedures combining internal tooth bleaching using Washi, gingivoplasty performed with electrosurgery using a 3D printed surgical guide, and ultrathin feldspathic porcelain veneers can achieve the desired results in the esthetic zone and remain successful for 4 years.
SUMMARY Bonding to enamel has been shown to provide reliable results, and thus conservative tooth preparations are key to the success of ceramic bonded restorations. The wax-up is the first diagnostic tool available to evaluate discrepancies between current and ideal tooth proportions. The clinician's diagnostic mock-up provides the patient with a visual perception of the size and shape of the proposed restorations. The use of reduction guides assists the restorative dentist in evaluating the specific amount of tooth structure to be removed during preparation. Furthermore, total isolation with a rubber dam prior to bonding the final restorations is crucial for the success of adhesive protocols. The aim of this report is to demonstrate a conservative approach to tooth preparation with a complete isolation technique prior to bonding eight ceramic restorations.