Direct Composite Veneers: A Simplified Approach - (Second Edition) A peer-reviewed article written by Ian E. Shuman, DDS, MAGD - Dental ...
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EARN This course was
3CREDITS
CE written for
dentists,
dental hygienists,
and dental assistants.
Direct Composite Veneers:
A Simplified Approach
(Second Edition)
A peer-reviewed article written by Ian E. Shuman, DDS, MAGD
PUBLICATION DATE: MARCH 2021
EXPIRATION DATE: FEBRUARY 2024
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ABSTRACT Image authenticity statement: The images in this
educational activity have not been altered.
Direct composite veneers serve as one method for restoring anterior teeth. Scientific integrity statement: Information shared in this
However, many dentists shy away from this procedure due to a lack of innate CE course is developed from clinical research and represents
the most current information available from evidence-based
artistic talent, lack of experience, past failures, and the length of time needed dentistry.
to complete the procedure. As a result, they opt for laboratory-fabricated Known benefits and limitations of the data: The
information presented in this educational activity is derived
alternatives, resulting in deep preparation designs. This course will demon- from the data and information contained in the reference
section.
strate the steps required to fabricate direct composite veneers in a highly
Registration: The cost of this CE course is $59 for three (3)
simplified manner using veneer templates and microhybrid composite resin. CE credits.
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1. Describe the properties of esthetic composite resin
2. Describe technique differences between direct and indirect veneers Endeavor Business Media
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3. Refer to the history of direct composite veneers for FAGD/MAGD credit.
4. Restore anterior teeth in a rapid manner using the materials outlined Approval does not imply acceptance by any
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with the steps discussed 11/1/2019 to 10/31/2022.
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QU I CK AC C E S S C O D E 21003
D ENTA L ACA D EM Y OF CON TIN U IN G ED U CATION
INTRODUCTION fixation of porcelain to enamel. resin restoration, therefore obtaining four
Veneers are created for patients based on a The reasons for choosing this treatment groups for the study.” They concluded that
multitude of needs. They may be required method can be many and varied. They a “composite resin restoration and a por-
to esthetically correct misalignment, form, include correction of esthetic concerns, celain veneer could perform similarly for
color, and spacing issues of anterior teeth. attrition and erosion, abfraction, fractures, replacing a fractured incisor edge up to
They may also be necessary to restore cari- caries, diastemas, restoring proximal con- 4 mm.”13
ous lesions. Regardless of need, veneers tact, occlusal discrepancies, the desire for
can be fabricated as indirect restorations a minimally invasive approach, and the METHODS
using porcelain or composite resin, or as financial limitations of the patient.5-10 Also, In the past, direct composite veneers
direct restorations using composite resin. of significant benefit is their use in medi- were fabricated using a host of materi-
With the direct method, the restorative cally compromised patients who display als and techniques. In 1976, Faunce and
material must be placed and completed in dental anomalies as secondary signs of Myers reported the “no-tooth-reduction”
one appointment. The final result depends conditions such as fluorosis and amelo- method of direct resin veneers using cold-
entirely on the proficiency and artistry of genesis imperfecta.11,12 cure bonding materials (Concise by 3M and
the dentist. However, the length of time A retrospective, longitudinal clinical Adaptic by Johnson & Johnson) polymer-
needed to perform this treatment and the study by Coelho-de-Souza et al. “investi- ized with the Nuva-Lite system (Dentsply/
difficulty of the technique have limited it to gated the performance of direct veneers Caulk).18 This technique was revolution-
those talented few with the proper abilities. using different composites (microfilled ary and would set the stage for a future
This alone is why many in our profession X universal) in vital or nonvital anterior in which composite veneers would be an
may choose or prefer to use indirect res- teeth . . . A total of 196 veneers were eval- everyday treatment. According to Faunce
torations. However, new resin restorative uated, with 39 failures.”5 They concluded and Myers, “Direct bonding of composite
materials and preformed veneer templates that “[d]irect composite veneers showed a resins to fractured or discolored teeth has
have opened this treatment modality to satisfactory clinical performance. Veneers been shown to be a practical and effective
any dentist regardless of skill level or cre- performed in vital teeth showed a better method for restoring teeth. Previously, lack
ative ability.1 performance than those placed in nonvi- of uniform shade matching and excessive
tal teeth.”5 bulkiness of material have been associated
DISCUSSION When compared to porcelain, research with full veneer bonding. The ultraviolet
Direct composite veneers are one option has shown that direct composite holds light (Nuva-Lite) in our studies penetrates
for veneering teeth, and for more than 60 up just as well.13-15 In a study by Rosen- veneers as thick as 2 mm and effectively
years the science and application of direct tritt et al., toothbrush abrasion and in vitro cures the filler material. We also have used
composite resin have grown and matured. aging on ceramic (indirect technique) and cold-curing bonding materials (Concise
The application of composite resin has composite veneers (direct technique) were and Adaptic) and they seem to be equally
progressed into a high-level service dem- investigated.16,17 A five-year period of oral effective, although working time is short-
onstrating excellent results, especially in service was simulated by thermal cycling ened. We have had no clinical problems
vital teeth. and mechanical loading. The results with this technique and after two years the
Historically, it is Charles Pincus, a Cali- showed that all materials had compara- veneers are intact. A technique has been
fornia dentist, who is credited with invent- ble wear resistance, failure rates, and sat- presented that requires no tooth reduction,
ing the veneer in 1928.2 The temporary isfying longevity. except where necessary for caries removal,
veneers were to be used for a film shoot, Batalocco et al. published a study with or time-consuming contouring and color
changing the appearance of the actors’ the aim of investigating “whether there is shading. Laminate veneers enable the
teeth. Nearly a decade later, Pincus fab- a direct correlation between the amount dental practitioner to obtain consistent
ricated acrylic veneers that had to be of residual tooth structure in a fractured esthetics with minimal chair time. Further
retained using denture adhesive, due to maxillary incisor and the fracture resis- evaluation of this technique to restore mal-
lack of adequate permanent adhesives. tance of composite resin restorations or formed, fractured, or discolored permanent
In 1959, the concept of acid etching by porcelain veneers after cyclic loading. incisors is being conducted.”18
Buonocore was the vanguard of adhesive Sixty human-extracted maxillary central More than a decade later, Larson and
dentistry, allowing the bonding of enamel and lateral incisors were mounted in an Phair reviewed the methods to duplicate
to porcelain veneers.3 acrylic block with the coronal aspect of the the intricate color distribution and surface
Research performed by Simonsen and tooth protruding from the block surface. texture of natural tooth structure using a
Calamia in 1982 demonstrated the acid The teeth were assigned to two groups: 2 direct bonded, microfilled composite resin
etching of porcelain using hydrofluoric mm incisal fracture and 4 mm incisal frac- veneer.19 “This technique creates a direct
acid.4 Thus, porcelain and composite ture. Then, the teeth were further divided bonded microfilled composite resin veneer
resins could achieve an adequate bond- into two different restoration subgroups, that replicates the complex color distri-
ing strength, resulting in the permanent porcelain laminate veneer and composite bution and surface texture of the natural
DentalAcademyOfCE.com 3
D ENTA L ACA D EM Y OF CON TIN U IN G ED U CATION
tooth structure. Duplicating the complex- developed including thin, prepolymerized, continue providing a high polish during
ity of natural tooth color can be repeated hybrid composite shells (Componeer sys- its lifetime.37
by recording the different layers of color tem, Coltene, Altstätten, Switzerland), and Microhybrid composite resins have
used in their sequence of placement.”19 more recently, laser-sintered, thermally been one of the preferred materials for
With time, this technique was improved tempered composite veneers (Edelweiss, direct veneering. They have the ability to
using opacifiers and tints and streamlined Ultradent) that demonstrate promise.26,27 retain a high polish similar to microfills,
with preformed transparent acrylic resin Other attempts have been made to with the strength of hybrid resin.
matrices and unique freehand methods.20-22 speed the process of direct resin veneers. The long-term maintenance of the sur-
In addition, other materials and proce- One such concept was the use of pre- face quality of materials is fundamental to
dures were introduced as a direct attempt formed, clear mylar matrices in the shape improving the longevity of esthetic resto-
to enhance the efficiency of these tech- of veneers with attached interproximal rations. Of great significance is the lifes-
niques.23 These included composite resins, strips in a variety of sizes (Mylaforms, pan of these materials, including strength,
opaquers, and tints for the “predictable res- Plastodontics). Another, the “split-splint” color stability, and polish, among others. In
toration of discolored anterior dentition technique, involved sending the lab an addition, having an average particle filler
with direct/indirect heat-treated compos- impression of the existing dentition.28 A size of 0.7 µm offers the ability to impart
ite resin veneers in a single appointment.”23 stone model was made and a technician a high polish and luster typically seen in
The “indirect-direct” application of would wax up the model as if in prepara- finer microfill resins.38-41 A study by Pala et
preformed acrylic laminate veneers with tion for creating indirect veneers. A refrac- al. “aimed to evaluate the flexural strength
bonded composite resin was attempted tory model was created upon which two and microhardness of three different ante-
(Mastique laminate veneers by DeTrey, vacuform shells were made. The soft shell rior composites after 10,000 thermocy-
Dentsply) with disappointing results.24 In was perforated on the midfacial for each cles.”41 It was concluded that the nanofill
a study by Høffding, these plastic veneers tooth to be veneered. These holes accom- composite “displayed significantly higher
were evaluated over four- and 10-year peri- modated the tip of composite compules. microhardness values. However, each resin
ods.25 It was found that they detached from Interproximal slits were made to allow composite was statistically similar for flex-
the tooth surface due to poor bond chem- clear matrices to be used to maintain clean ural strength values. Ten thousand thermo-
istries, demonstrated a low resistance to contacts and reduce the amount of cleanup cycles significantly affected microhardness
abrasion, and exhibited marginal leakage required. The rigid shell helped maintain and flexural strength.”41
and discoloration. the final form prior to curing. Regardless Direct composite template: Follow-
Høffding reported that the purpose of technique, success or failure is often ing in the tradition of simplified direct ante-
of the study was “to evaluate the clinical dependent on the material used to achieve rior veneers, a system has been created to
quality over four years and the longev- the end goal. ease the difficulty and shorten the time
ity over 10 years of 77 Mastique laminate needed for the process. A kit of 32 autoclav-
veneers (DeTrey, Dentsply). The veneers MATERIALS able, translucent templates in two univer-
were bonded to incisors and canines with Direct composite resin: Direct compos- sal sizes that mimic the precise anatomic
a light-cured composite resin, using the ite resin should fluoresce and bear opal- facial contour of upper and lower teeth,
acid-etch technique, and examined every escent qualities of natural tooth structure, including the second premolars, is avail-
1/2 year in accordance with USPHS cri- especially since patients are seen under able (UVeneer, Dental Art Innovations, St.
teria. Anatomic form and marginal adap- various lighting conditions.29,30 It should Kilda, Australia). The templates can be
tation were rated excellent in more than have low-translucent, high-fluorescent used with any preferred composite mate-
50% of the veneers throughout the study. dentin shades, combined with highly trans- rial, producing consistent, predictable, per-
Moderate surface wear was seen in most lucent/opalescent enamel shades to facili- fect results with regard to final tooth shape,
of the veneers after four years of service. tate the superior reproduction of natural shine, and smile design.
Marginal discoloration and color match teeth.31,32 The composite resin should be Following tooth preparation and routine
were recorded as not acceptable in 20% sculptable with enough body to prevent adhesive bonding techniques, composite
of the veneers at the four-year control. No slumping and be easy to polish, offering a resin is applied to the entire restorable
significant difference was found in the gin- high luster.33-35 A perfect match to either surface, and the template is then pressed
gival index between veneer and control stock or custom shade guides is a must, onto the composite. Once excess material
teeth. The cumulative retention rate was and the system should be available in many has been removed and the interproximal
40% after four years and 20% at the 10-year shades. A high radiopacity is necessary areas adequately separated and contoured,
recall. Owing to the high frequency of spon- to distinguish the restoration from both the composite is light cured through the
taneous loss, Mastique laminate veneers tooth structure and future caries.36 In addi- template. With a nonstick surface, the
cannot be recommended as permanent tion, the composite should have a regular template is removed, leaving a high-gloss
restorations.”25 or average filler particle size to avoid pit- finish. The template offers the additional
Iterations of this concept were ting during finishing and polishing and benefit of removing the oxygen inhibition
4 DentalAcademyOfCE.com
D ENTA L ACA D EM Y OF CON TIN U IN G ED U CATION
shades using a layering technique.”45 This
simplified method is one that less-experi-
enced practitioners can embrace.
APPLICATIONS
In addition to direct composite veneers,
preformed universal veneer templates offer
other benefits in clinical practice:
• Ease of use
FIGURE 1: Case presentation • Can enhance clinic productivity
significantly
• Saves time—no need to spend time and
effort on carving and polishing
• Requires minimal preparation
• Cost effective
When to use UVeneer:
• For all composite veneer applications,
for one or multiple teeth, to correct dia-
stemas, fractures, abrasions, discolored FIGURE 4: Placing flowable composite
or mispositioned teeth, caries resto-
ration, and other esthetic corrections
FIGURE 2: False pocket • For the creation of temporary veneers
between appointments while porce-
lain veneers are being made in the lab
• For direct chairside mock-ups before
conducting the procedure
• Class V, and full-veneer coverage from
one tooth up to 10 teeth per arch, from
central incisor to second bicuspid
• Direct composite veneer restorations
• Cosmetic preview mock-up and shade
FIGURE 3: Surgery with a diode laser selection
• Temporary veneers
layer (similar to the finish after mylar strip • Laboratory model wax-up
removal), thereby increasing composite
strength.42 CASE REPORT FIGURE 5: UVeneer templates tried against teeth
This system offers several distinct The patient, a 23-year-old female, pre-
advantages. At its most basic, there is an sented for a routine prophylaxis and exam.
economy of material and time: The tem- Due to a history of allergy-induced mouth
plate dictates the amount of composite breathing and medication-induced xero-
resin needed per tooth, preventing waste stomia, the desiccated anterior teeth had
and thereby avoiding the overbuilding/ multiple carious lesions ( figure 1). Often
cutback process. Also, because of the originating as “white spots,” these occult
variants in template contour, a greater lesions are found in patients due to a
amount of composite is imparted in the variety of reasons including diet, fluoro-
midfacial and less as the restoration pro- sis, enamel hypoplasia, plaque accumu-
gresses toward the inciso/gingivo/facial lation, and dehydration. In addition, the
aspects.43,44 In an article by Lowe, this idea teeth were malpositioned and the mar-
was described as follows: “. . . this var- ginal tissue inflamed.
ied thickness of material creates differ- Following a smile evaluation, it was
ent effects and values and, as a result, explained to the patient that her wide
only one shade of composite is needed smile allowed visibility of the posterior
in many cases to get a natural gradient teeth bilaterally. It was agreed that com-
effect, obviating the need to use different posite veneers would be placed from the FIGURE 6: Aligning UVeneer
DentalAcademyOfCE.com 5
D ENTA L ACA D EM Y OF CON TIN U IN G ED U CATION
that the biologic width was not violated. opportunity to increase practice income.
Surgery was performed on the tissue using Now, dentists can give patients the
a diode laser ( figure 3). option of composite veneers without hes-
Following the removal of the carious itation. UVeneer is a kit system that can
lesions, mylar strips and/or Teflon tape was be used to create final provisional veneer
inserted between the teeth. The prepara- restorations for one or multiple teeth; to
tions were then etched, rinsed, and dried. A correct diastemas, fractures, abrasions,
fifth-generation bonding agent was applied and discolored or malpositioned teeth; for
and cured. A flowable composite was used caries restoration; for intraoral mock-ups;
to restore these small, irregular areas ( fig- for study model correction; for communi-
ure 4). cation with the lab technician or ortho-
Next, the appropriate UVeneer tem- dontist; and for any other situation when
plates were selected from the kit and tried a rapid, perfectly formed composite fac-
against the teeth ( figure 5). A B1 shade ing is needed.
composite was selected and applied to the It has been demonstrated that the use
entire surface of the upper right central of a well-formed provisional restoration
incisor. The central line on the UVeneer offers the ability to maintain oral health
FIGURE 7: Removing template after curing composite template was aligned with the long axis and promote healing of a surgical site.
of the tooth and gently pressed ( figure 6). Using the technique of a fiber-reinforced,
Excess composite was removed around the directly fabricated provisional prior to
edges of the veneer to reduce the need for extraction is a simple, elegant way to pro-
trimming after curing. The composite was vide this type of care. The technique dem-
then cured through the UVeneer template. onstrated in this case report is simple,
The template was removed by pulling on reliable, and repeatable.
the handle ( figure 7). Additional excess
resin was removed from the margins of REFERENCES
the veneer. 1. Minguez N, Ellacuria JJ, Soler JI, et al. Advances
FIGURE 8: Restoring remaining teeth The remaining teeth were restored in the history of composite resins. J Hist Dent.
in the same manner ( figure 8), and the 2003;51(3):103-105.
direct composite veneers were polished 2. Pincus CL. Building mouth personality.
as needed ( figure 9). One week later, the Paper presented at: California State Dental
soft tissues appeared healed and healthy Association. 1937. San Jose, California.
( figure 10), and the patient was placed on 3. Buonocore M, Wileman W, Brudevold F. A
four-month recare. report on a resin composition capable of
bonding to human dentin surfaces. J Dent Res.
FIGURE 9: Polishing the direct composite veneers CONCLUSION 1956;35:846-851.
It is now possible for any dentist to con- 4. R.J, Calamia JR. Tensile bond strengths
sistently and cost effectively produce com- of etched porcelain [abstract]. J Dent
posite veneers that are predictable in final Res. 1983;62(Spec Iss):1099.
tooth shape and smile design. The UVe- 5. -de-Souza FH, Gonçalves DS, Sales MP, et al.
neer system has eliminated those barriers Direct anterior composite veneers in vital
so that virtually any practitioner can now and non-vital teeth: A retrospective clinical
accomplish this in a short amount of time, evaluation. J Dent. 2015;43(11):1330-1336.
with the results being a perfectly designed 6. B, Yanıkoğlu F, Günday M. Direct composite
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right to left upper second premolars. also use layering techniques. The UVeneer 7. A, Burnside G. The survival of direct composite
Following local anesthesia, the gingival process removes several shortcomings of restorations in the management of severe
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A false pocket caused by lingual malpo- ness, sizing, shade restrictions, cost, and prospective 8-year study. J Dent. 2016;44:13-19.
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6 DentalAcademyOfCE.com
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St-Pierre L, Martel C, Crépeau H, Vargas technique for diastema closure (three- dental composite resin materials. J Dent. MA. Influence of polishing systems on dimensional finite element stress analysis). 2013;41(9):771-778. surface roughness of composite resins: Dent Med Probl. 2019;56(2):179-183. 31. Blank JT. Creating translucent edge effects and polishability of composite resins. Oper Dent. 16. Haralur SB, Alqahtani AS, AlMazni MS, Alqahtani maverick internal tints using microhybrid resin. 2019;44(3):e122-e132. MK. Association of non-carious cervical lesions Pract Proced Aesthet Dent. 2006;18(2):131-136. 44. Ehrmann E, Medioni E, Brulat-Bouchard N. with oral hygiene habits and dynamic occlusal 32. Mourouzis P, Koulaouzidou EA, Palaghias G, Finishing and polishing effects of multiblade parameters. Diagnostics (Basel). 2019;9(2):43. Helvatjoglu-Antoniades M. Color match of resin burs on the surface texture of 5 resin 17. Rosentritt M, Sawaljanow A, Behr M, et al. composites to intact tooth structure. J Appl composites: microhardness and roughness Effect of tooth brush abrasion and thermo- Biomater Funct Mater. 2015;13(3):e259-e265. testing. Restor Dent Endod. 2019;44(1):e1. mechanical loading on direct and indirect 33. Chiang YC, Knezevic A, Kunzelmann KH. 45. Lowe RA. Simplifying direct composite veneer veneer restorations. Clin Oral Investig. Slumping during sculpturing of composite placement. Dent Today. 2015;34(5):98,100-103. 2015;19(1):53-60. materials. Dent Mater. 2008;24(12):1594-1601. 18. Faunce FR, Myers DR. Laminate veneer 34. Costa de Morais R, Garcia L, Cruvinel D, IAN E. SHUMAN, DDS, restoration of permanent incisors. J Am Dent Pires-de-Souza F. Color stability and surface MAGD, maintains a general Assoc. 1976;93(4):790-792. roughness of composite submitted to different reconstructive and esthetic 19. Larson TD, Phair CB. The use of a direct bonded types and periods of finishing/polishing: dental practice in Pasadena, microfilled composite resin veneer. J Am Dent physical properties of composites. J Contemp Maryland. He is a master in the Assoc. 1987;115(3):449-453. Dent Pract. 2015;16(7):565-570. Academy of General Dentistry 20. Mendoza AM, Reina ES. Direct composite 35. Çelık EU, Aladağ A, Türkün LŞ, Yilmaz G. Color and a fellow of the Pierre esthetic veneers: use of opacifiers and tints. changes of dental resin composites before and Fauchard Academy. Dr. Shuman has been named Rev Actual Estomatol Esp. 1988;48(378):45-48. after polymerization and storage in water. J one of the Top Clinicians in Continuing Education 21. Baratieri LN, Monteiro Júnior J, de Andrada Esthet Restor Dent. 2011;23(3):179-188. since 2005 by Dentistry Today. MA, Aracari GM. Composite resin veneers: 36. Cruz AD, Costa I, Calazans FS, et al. DentalAcademyOfCE.com 7
QUICK ACCES S CO DE 21003
ONLINE COMPLETION
Take this test online for immediate credit. Visit dentalacademyofce.com and sign in. If you have not previously purchased the course, select it from the “Online Courses” listings
and complete your purchase. The exam will then be added to your “Archives” page, where a “Take Exam” link will be provided. Click on this link, complete all questions, and submit your
answers. An immediate grade report will be generated. If you receive a score of 70% or higher, your verification form will be provided immediately for viewing and printing. View and print
forms at any time by visiting the site and returning to your “Archives.”
QUESTIONS
1. Many dentists avoid placing direct 6. Which of the following dental 11. In the case report, what was the
composite veneers due to: anomalies can benefit from direct patient’s recare frequency?
A. Lack of innate artistic talent composite resin veneers? A. Every 3 months
B. Lack of experience A. Fluorosis B. Every 4 months
C. The length of time needed to B. Amelogenesis imperfecta C. Every 6 months
complete the procedure C. A and B D. Every 9 months
D. All of the above D. Meniere’s disease
12. What is the average particle filler
2. Veneers may be required for 7. Rosentritt conducted a study size that offers the ability to impart
all of the following except: evaluating toothbrush abrasion and a high polish and luster typically
A. Form in vitro aging on what materials? seen in finer microfill resins?
B. Esthetic correction of existing A. Ceramic A. 0.7 µm
proper alignment B. Direct composite (veneers) B. 0.07 µm
C. Color C. Titanium C. 7.0 µm
D. Spacing D. A and B D. None of the above
3. In a study by Coelho-de-Souza 8. Prior to curing, direct composite 13. UVeneer can be used for all
et al., the application of which resin should be sculptable with except which of the following?
of the following has progressed enough body to prevent: A. Temporary veneers
into a high-level service A. Slumping B. Molars
demonstrating excellent results? B. Premature curing C. Direct composite veneer restorations
A. Composite resin in vital teeth C. Dulling D. Cosmetic mock-up
B. ¾ crowns D. None of the above
C. Laminates 14. Which of the following
D. None of the above 9. Direct composite should exhibit a composite resin types has been
high radiopacity on radiographs to one of the preferred materials
4. The reasons for choosing direct distinguish the restoration from: for direct veneering?
composite for veneering include: A. Periodontal ligament A. Macrohybrid
A. Occlusal discrepancies B. Partial framework B. Macrofill
B. Attrition and erosion C. Alveolar bone C. Microhybrid
C. Its highly invasive approach D. Tooth structure and caries D. None of the above
D. A and B
10. Direct composite resin should have: 15. Pincus fabricated acrylic veneers
5. The reasons for choosing direct A. Low-translucent, high- that had to be retained using
composite for veneering include fluorescent dentin shades denture adhesive, due to lack
all but which of the following? B. A nitrogen inhibition layer of adequate permanent:
A. Fractures C. High-translucent, low- A. Adhesives
B. Abfraction fluorescent dentin shades B. Etching
C. Caries D. Lines of demarcation at the margins C. Polishing
D. Opening proximal contacts D. A and B
8 DentalAcademyOfCE.com
QUICK ACCES S CO DE 21003
ONLINE COMPLETION
Take this test online for immediate credit. Visit dentalacademyofce.com and sign in. If you have not previously purchased the course, select it from the “Online Courses” listings
and complete your purchase. The exam will then be added to your “Archives” page, where a “Take Exam” link will be provided. Click on this link, complete all questions, and submit your
answers. An immediate grade report will be generated. If you receive a score of 70% or higher, your verification form will be provided immediately for viewing and printing. View and print
forms at any time by visiting the site and returning to your “Archives.”
QUESTIONS
16. Who reported the “no-tooth- 21. In the clinical case presented, caries 26. The template is removed
reduction” method of direct of the anterior teeth was due to: after curing by:
resin veneers using cold- A. Home care A. Pulling on the handle
cure bonding materials? B. Xerostomia B. Chemical means
A. Faunce and Myers C. GERD C. Heating
B. Martin and Lewis D. All of the above D. Tapping
C. Parker and Barrow
D. Hale and Denver 22. The upper left lateral incisor was 27. In the case discussed, what
probed prior to the gingivoplasty shade was selected?
17. What feature is necessary to to ensure that which of the A. A1
distinguish the composite following was not violated? B. B1
restoration from tooth A. Biologic width C. A2
structure and future caries? B. The Q continuum D. A3
A. Macro particles C. Mucogingival junction
B. Radiolucency D. B and C 28. At its most basic, using preformed
C. Carbon nanotubes composite veneer templates
D. High radiopacity 23. In the case presented, offers an economy of:
a gingivoplasty was A. Material
18. The correct sequence of performed using a: B. Salary
treatment, tooth preparation— A. Microscalpel C. Time
adhesive bonding—apply B. Diode laser D. A and C
composite—seat template—cure, C. A and D
is necessary for which device D. Diamond bur 29. Which of the following dictates
mentioned in this course? the amount of composite resin
A. Mastique 24. Following the removal of the needed per tooth to prevent waste?
B. Edelweiss carious lesions, what was A. Interproximal matrix
C. UVeneer template inserted between the teeth? B. The remaining enamel only
D. None of the above A. Mylar strips C. Template
B. Teflon tape D. All of the above
19. Which one of the following is not C. Stainless steel matrix
a preformed laminate veneer? D. A and B 30. A greater amount of composite is
A. Edelweiss imparted in the midfacial and less
B. Componeer 25. Prior to curing, what must be as the restoration progresses toward
C. Mastique aligned on the UVeneer template? the inciso/gingivo/facial aspects
D. Ridgway A. The intercuspid line because of the variants in template:
B. The scribed horizontal line A. Contour
20. Which of the following are C. The scribed vertical line B. Handle angulation
universally sized, autoclavable, D. All of the above C. Pressure
translucent templates? D. None of the above
A. UVeneer
B. Mastique
C. Split-Splint
D. Mylaforms
DentalAcademyOfCE.com 9
PUBLICATION DATE: MARCH 2021 ANSWER SHEET
Direct composite veneers:
EXPIRATION DATE: FEBRUARY 2024
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3. Refer to the history of direct composite veneers
4. Restore anterior teeth in a rapid manner using the materials outlined with the steps discussed
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