The impression material was manipulated according to the manufacturer’s instructions. The selection of an appropriate treatment plan for cases of dental fluorosis depends on the severity of the condition. Ceramic veneers are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results of these veneers. We will restrict ourselves to severe fluorosis because it is most noticeable and bring about most social psychological harm in most people who get it. Copyright © 2018 Aminah M. El Mourad. Treatment of Severe Fluorosis Dr. Gaurav Gupta. COVID-19 is an emerging, rapidly evolving situation. The most noticeable effect of dental fluorosis is teeth discoloration. Den Bestan P. K. Dental fluorosis: its use as a biomarker. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. NIH Aminah M. El Mourad, "Aesthetic Rehabilitation of a Severe Dental Fluorosis Case with Ceramic Veneers: A Step-by-Step Guide", Case Reports in Dentistry, vol. Maxillary tooth preparation: (a) frontal view, (b) lateral view: right side, and (c) lateral view: left side. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 2009 Jun 29;2:8329. doi: 10.4076/1757-1626-2-8329. We will be providing unlimited waivers of publication charges for accepted research articles as well as case reports and case series related to COVID-19. The patient decided to postpone veneering his lower teeth, given his limited financial capacity. The desired shade was selected using the VITAPAN classical shade guide (VITA Zahnfabrik, Germany). doi: 10.1002/14651858.CD005512.pub3. This goal was achieved using ceramic veneers, which are the treatment of choice to mask tooth discoloration in cases of moderate to severe fluorosis. - teeth whitening, microabrasion, resin infiltration, restoration placement. The aim of the treatment in this case was to improve the patient’s smile and aesthetic rehabilitation of teeth. The fluoride level in the water around Taiz Province is >3.6 mg/l [8]. Afterwards, veneers were prepared for bonding. Furthermore, numerous studies have demonstrated acceptable aesthetic outcomes in cases of moderate to severe fluorosis where restoration with porcelain veneers was performed [14]. Ceramic veneers are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results of these veneers. The clear matrix that was previously fabricated was loaded with a temporization material (Protemp Plus, 3M ESPE, MN, USA) and placed over the prepared teeth. Aesthetic Rehabilitation of a Severe Dental Fluorosis Case with Ceramic Veneers: A Step-by-Step Guide, Department of Restorative Dental Sciences, King Saud University, Riyadh, Saudi Arabia, P. K. Den Bestan, “Dental fluorosis: its use as a biomarker,”, A. J. Spencer, G. D. Slade, and M. Davis, “Water fluoridation in Australia,”, M. S. Hopcraft, K. E. Yapp, G. Mahoney, and M. V. Morgan, “Dental caries experience in young Australian Army recruits 2008,”, O. Fejerskov, M. J. Larsen, A. Richards, and V. Baelum, “Dental tissue effects of fluoride,”, E. S. Akpata, “Occurrence and management of dental fluorosis,”, P. Denbesten and W. Li, “Chronic fluoride toxicity: dental fluorosis,”, B. T. Rotoli, “Porcelain veneers as an alternative for esthetic treatment: clinical report,”, A. Aqeel, A. Al-Amry, and O. Alharbi, “Assessment and geospatial distribution mapping of fluoride concentrations in the groundwater of Al-Howban Basin Taiz-Yemen,”, A. Thylstrup and O. Fejerskov, “Clinical appearance of dental fluorosis in permanent teeth in relation to histologic changes,”, M. Peumans, B. eCollection 2019. Minimal gingival flash of the resin luting cement was removed with a number 12 scalpel blade. [Application of all-ceramic laminates veneer with Vita VM9 in clinic]. It’s through fluorides direct effects on ameloblasts, the developing matrix and processing of the matrix that disrupts normal development().This disruption can happen when permanent teeth come in (at the age of 8) or when baby teeth come in (around the ages of 1-2)(). Flossing was performed to ensure interproximal contact patency. Light curing was first performed for 2 seconds, and the excess resin cement was removed with a microbrush. Ceramic veneers are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, … The durability and clinical success of porcelain veneers have been widely investigated in the literature. Al Warawreh AM, Al Tamimi ZH, Al Qatawna MI, Al Momani AA, Al Mhaidat MR, El Naji WS, AlSaraireh S. Int J Dent. Preoperative clinical photographs: (a) smile, (b) frontal view, (c) lateral view: right side, and (d) lateral view: left side. The patient agreed to smile enhancement using ceramic veneers for his upper teeth given that he desired an optimum aesthetic and a long-term result. Final surface lustre was achieved by using a diamond polishing paste with a rubber prophylaxis cup. Bleaching and microabrasion have been recommended for treating mild cases of fluorosis; however, in moderate to severe cases, bleaching and microabrasion are either ineffective or may lead to only transient improvement [6], while composite restorations are prone to discoloration, chipping, and debonding. Diagnostic models were analyzed to evaluate the occlusion, and a diagnostic wax-up was made of white-colored wax. We are committed to sharing findings related to COVID-19 as quickly as possible. 1994;8(1):105–110. A clear mylar strip was placed interproximally to prevent inadvertent bonding to the adjacent tooth and to facilitate the subsequent removal of excess resin cement in the embrasures. USA.gov. Numerous studies have reported that water fluoridation is a safe and effective public health measure for reducing the occurrence of dental caries [2, 3]. This site needs JavaScript to work properly. Pictures- snow capping (mild), mottling, brown (severe). However, excessive fluoride in drinking water, exceeding a concentration of 0.5–1.5 mg/l, can lead to metabolic alteration in ameloblasts; this results in a defective matrix and improper calcification of teeth, known as dental fluorosis [4]. The postoperative clinical photographs are shown in Figure 4.

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