The Uveneer System (Ultradent Products) is a clear template kit that provides dentists with preformed facial surfaces of maxillary central and lateral incisors, canines, and premolars. It has been designed to make it easier and faster for dentists to create direct composite veneers with predictable shape and symmetry. Uveneer templates come in 2 sizes to better fit the facial profiles of most teeth. The size of the templates is made to match ideal 80% width-to-length ratios and to correspond to smile design proportion (“golden proportion”) mesio-distal widths of 1.6-mm central incisor to 1.0-mm lateral incisor to 0.6-mm canine. With the nuances of facial proximal line angles, proper heights of contour and facial outline form in the template, Uveneer provides a fast and predictable way to create anatomically beautiful direct composite veneers in a fraction of the time when compared to traditional freehand sculpting and contouring. The clear Uveneer template is pressed over composite that has been laid on the tooth after etching and placement of bonding resin. For teeth that are more severely damaged and require replacement of dentin, Uveneer may be used to place the final anatomic “enamel” layer after building up the dentin (inner) layer of the restoration freehand. The template is removed after the enamel composite material is light-cured, thus creating a perfectly contoured facial surface. The composite surface will already be glossy due to the lack of an oxygen-inhibited layer, so if no further alteration is required, the finish on the veneer is complete without additional polishing steps. In cases where the templates are not as perfect of a fit, minor contouring and polishing may be required, but the time savings in placement is significant because of the preformed facial anatomy. Uveneer templates are easy to handle, have a nonstick surface, and are autoclavable and therefore reusable. Any type of composite can be used with the Uveneer System, and the dentist can use a single- or multiple-layer technique, if desired. Direct composite veneers created using the Uveneer System are beautifully aesthetic and can be placed with a significant decrease in chair time, making the process a more affordable option for the patient. Placement can be minimally invasive and does not rely on the artistic skill of the operator to get a beautiful aesthetic result.
|Figure 1. A preoperative smile of a 15-year-old patient after orthodontic treatment.||Figure 2. A fiber reinforcement
material (everStick C&B [GC America]) is used on the lingual surfaces between teeth Nos. 9 and 11 to “bridge” the space of the missing lateral incisor. Once bonded to place, it is covered with flowable composite resin.
|Figure 3. The dentin pontic is built out of the appropriate shade of
composite resin (Vitalescense [Ultradent Products]).
|Figure 4. A small amount of flowable resin (PermaFlo Flowable Composite [Ultradent Products]) in the enamel shade is brushed into the Uveneer template prior to placement on the enamel increment, which has been dispensed on the facial surface of the pontic.|
|Figure 5. After placement of the enamel layer, either on the tooth or in the Uveneer template, the template is pushed onto the pontic surface, expressing a slight amount of excess around the periphery as the template is placed in the proper labial position in the same facial plane as the adjacent teeth.||Figure 6. Using a plastic composite instrument (Golstein Flexithin Mini 4 [HuFriedy]), the excess composite is removed from the periphery of the Uveneer template.|
|Figure 7. A postoperative view of the completed restoration of the congenitally missing maxillary left lateral incisor using fiber reinforcement, direct composite resin, and Uveneer to recreate the labial surface of the restored tooth. The peg lateral (tooth No. 7) on the maxillary right was restored with direct composite using Bioclear matrices (bioclearmatrix.com) to restore beautiful proximal contours to the anatomically defective tooth.|
A common problem faced by orthodontists and restorative dentists is how to handle post-orthodontic patients with congenitally missing lateral incisors (Figure 1). Most of these patients are younger than age 20, with long-term solutions that are less than conservative for patients of that age. Often, these patients wear removable flipper or Essix-type prostheses for many years, which are problematic and unaesthetic at best and not very good solutions for young patients in their late teens. Also, removable appliances in contact with the tissue for extended periods of time can cause further loss of soft tissue and bone, creating a difficult aesthetic issue when implants are eventually placed.
Light-cured composite in conjunction with fiber reinforcement offer these patients a better intermediate or long-term solution for this restorative dilemma in one visit, with no laboratory cost. An appropriate length of fiber is measured and placed either as an intracoronal or extracoronal splint (retainer), using total-etch, adhesive, and flowable resin (Figure 2). Next, a direct composite pontic can be sculpted directly to it, closing the space (Figure 3). Once the pontic is formed, Uveneer is used to place the anatomic enamel veneer on the labial surface of the pontic (Figures 4 to 6). Not only can a beautifully aesthetic restoration be made with little or no preparation (depending on the occlusal relationship of the patient), but also this type of restoration is economical to place and is easily repaired should it fracture at any time under functional stress. Maryland-type ceramic restorations do not offer either of these advantages. This economical restorative solution is completed in a single patient visit and does not preclude placement of conventional bridgework or implants at a later time in life (Figure 7).
The case presented describes only one of many creative uses for the Uveneer templates in the restorative practice. Others include multiple-unit direct composite veneer placement, fast intraoral composite mock-ups for patients to view a trial smile, and composite mock-ups on stone models that can be used in the fabrication of provisional crown and bridge restorations without the need in many cases for costly laboratory wax-ups.
The Uveneer System is a multifaceted product that can be used by every dentist in restorative practice to raise the level of his or her artistic ability.
For more information, contact Ultradent Products at (800) 552-5512 or visit the website ultradent.com.