COMPONEER™ In difficult cases.


Dental News Volume XXII, Number IV, December, 2015


By Dr. Mario José Besek








COMPONEER™ is an new generation of front teeth restoration. It is a direct “chairside“ veneering technique based on composite and offers a lot of advantages. Componeers are prepolymerized enamel shaded composite shells, which enables an easier procedure in the freehand technique with composites. The prefabricated componeers, that can be individualized leads into better marginal adaptation and have a 100% connection to the restoration composite, are completely homogeneous and free of voids  with a thickness of onlay 0.3mm. The anatomical basic form consists of different sizes and colors which makes the work easier. The correction of unlikely teeth, malpositions and  less smile presence seems to be more and more important for patient and dentist.  Also the cost – benefit relationship is a criteria, natural beauty, minimal invasive procedure, ability of individualization, repair possibility and technical and dental feasibility. All these basic considerations were inducing the development of COMPONEER™, because it fulfills all criteria. Following different therapy concepts are compared with the COMPONEER™-system and limiting factors were discussed.

When we re-create front teeth esthetic, different techniques are available: orthodontic treatment, indirect labmade crowns and veneers, direct CAD/CAM technique (Cerec), direct prefabricated and individualized ceramic veneers (Lumineer, Cerinate etc.), freehand technique with composite, and newly direct composite veneers, especially COMPONEER™. The enumerating was consciously chosen, because it is representing the change of dental techniques over the time and also the requirements of modern patients. Of course in case of malpositioned teeth sometimes orthodontics is the only and the most minimally invasive treatment and sometimes are here limits and limitations reached (Fig 1). Missing or deformed teeth makes the treatment more difficult and leads into a reconstructive treatment with higher costs.

Fig 1



The readiness for adults for orthodontics becomes smaller and in need for esthetics, mostly crown and veneer technology are used. Tooth substance loss using porcelain veneers is less, but when the teeth are malpositioned, the treatment is not possible. All indirect techniques are time consuming, material intensive, painful and combined with high costs. To reduce several factors chairside veneering was introduced with ceramic (Cerec). Lab costs were reduced but in the same time also the indications. Esthetic becomes more and more important and different direct Ceramic systems were introduced, but in difficult cases not feasible. Esthetic was for decades the domain of prosthodontics, where innumerably teeth were heavily prepared. New techniques, materials and the knowledge about adhesion forces, made us think differently. With suitable concepts it is possible today to offer durable esthetic solutions, saving tooth substance and money. New composite materials allow with the direct restoration technique to make a direct blending without too much preparation.

The liming factor is the homogeneity of the most composite materials which leads often in surface porosity or discoloration. A perfect adhesion at the margins is also required. In the case of ceramics, we have limitations because of the “sandwich“ technique and adhesion to Ceramic is about 30% less than on enamel or composite. Aging of the marginal integrity can sometimes start earlier (Fig 2). Direct ceramic veneers can not be individualized or finished at the margins. If the surface is finished through the material, discoloration will start here first  (Fig 3). But also direct composites has some shortcomings as porosities are finding a way when shaping and texturing the anatomical form. It makes sense to use prefabricated composite veneers and seating it with the same material. But they must be completely homogeneous so that they can be finished and individualized, a surface glaze will be counterproductive (Fig 4). Especially in difficult cases with malpositioned teeth it is important to be able to form the surface  with rotating instruments.

COMPONEER™ is a new concept, with brings the direct veneering technique with composite to a pole position. The concept of “direct Veneering“ is less invasive and with the help of new materials and techniques it can expand the range of indications and takes a new position in esthetic dentistry considering economics and quality.

The unique microretentive surface of COMPONEER™ (2µm) (Fig 5), simplifies the conditioning, because no additional sandblasting or salinization is necessary. In  combination with bond and restoration material it leads to a 100% copolymerisation and a monophase, existing in composite. At the end we have a better marginal adaptation, higher fracture resistance and less discoloration (Fig 6).

Fig 2

Fig 3

Fig 4

Fig 5

Fig 6



Do we have to remove older restorations? We can use the componeer as a mold or matrice and it will be placed directly with dentine mass. This technique can also be used for tooth lengthening or closing diastema. Correcting toothform- and position the base of the teeth can be preformed with dentine composite to reach a normal tooth profile.

COMPONEER™ has a shallow anatomical surface texture that allows to accentuate the surface individually or to adapt the form to the face and papilla line. A few example shall show how COMPONEER™ behaves, compared to other systems. For an optimized result, a previous diagnostic with composite without tooth-conditioning is recommended (Fig 7 & 8). COMPONEER™ can be a helpful tool if patients can not be definitively restored such like the 10 years old girl with amelogenesis imperfecta, where the treatment has to be fast and efficient without any trauma (Pic.09 &10).

Fig 7

Fig 8

Fig 9

Fig 10



In case of malpositioned teeth, wrong toothform (Fig 11), with any other system the teeth has to be prepared more; with COMPONEER™ especially on younger people in combination with composite, esthetics can be attained minimal-invasively (Fig 12). Edge-to-edge bite leads normally to heavy tooth preparation for traditional veneers (Fig 13 & 14).

Fig 11

Fig 12

Fig 13

Fig 14



The following case shows different problems; 14 is too palatal, 13 too buccal, 12 in crossbite, 22 is missing with a small gap to 23, 24 is missing with a small gap to  25 (Fig 15). The tooth #12 was only cut incisally back to solve the crossbite, between 21 and 23 with the help of a fiberband a composite – pontic was preformed and optically slightly overlayed on 23 to maintain the proportion of the teeth; following, the tooth anatomy was completed with COMPONEER™ (Pic.16).
In the last case, the patient refused an orthodontic treatment (Pic.17). Using an indirect technique in this case would lead into heavy preparation and devitalisation of teeth. (Pic.18). For the direct restoration with COMPONEER™ only a minimalinvasive preparation was needed (Pic.19). The base of the toothbow was equalized with composite and componeer were placed on the top. Because componeers are completely homogeneous the shape of tooth curvature could be adapted. (Pic.20).

The Componeer system has a target to optimize restorative dentistry in that way that patient and dentist can benefit in the same way and emphasizes new possibilities in esthetic dentistry with direct restorations. The main advantage contains the minimal invasive procedure, new indication possibilities and the high potential of individualisation. Less damage potential for more attractivity.

Fig 15

Fig 16

Fig 17

Fig 18

Fig 19

Fig 20











Comments

  1. One of my friend has recently got done his componeer fixed at a dental clinic in Mumbai called Dentzz. She got them fixed on the upper teeth and now her smile looks more beautiful & the whole treatment was done in single sitting. That's quite impressive!

    ReplyDelete
  2. This comment has been removed by a blog administrator.

    ReplyDelete

Post a Comment

Popular posts from this blog

Molar Incisor Hypomineralization (MIH): Conservative Treatment Approach

Tooth Size Discrepancy Importance As a Diagnostic Tool for Orthodontic Treatment Planning: A Review

Tooth Staining and Discoloration: a review of literature. Part I: Etiology and Classification