經牙齒美白後以陶瓷貼片復形左上正中門齒－－病例報告

Restoring upper Left Central Incisor with a Porcelain Laminate Veneer after Bleaching: A Case Report

二矽酸鋰強化玻璃陶瓷具有透明度兼具美觀及功能，適合用來製作前牙贋復物，本病例報告為一位年輕女性，左上正中門齒為牙冠斷裂後有一樹脂填補物，但困擾於樹脂顏色長期穩定性較差，希望尋求較長久穩定的補綴物。患者自然齒列顏色偏黃，且有先天色斑，因此希望能改善整體美觀。經過全口檢查，確認無蛀牙後，經全口牙齒美白技術將自然牙顏色漂白後，色斑、色點等顏色變得較不明顯。進行美觀分析診斷蠟型，發現左上正中門齒較右上正中門齒寬約0.5毫米，藉由改變左上正中門齒陶瓷貼片的線角來達到視覺對稱，並模擬右側正中門齒其齒頸部較深的顏色及牙齒表面的白點來達到擬真自然的效果。二矽酸鋰(lithium disilicate)強化玻璃陶瓷的貼片經由良好的表面處理及黏著能達到美觀與強度兼備的結果。

Porcelain laminate veneers (PLV) made with pressed lithium disilicate have excellent translucency and strength, making them a good option when restoring anterior teeth. Compared with composite resin, porcelain also has a better resistance to wear and discoloration. Herein, we present a case involving a young female patient who had several years prior incurred a crown fracture in her left maxillary central incisor. She had undergone several composite resin restorations of this tooth, but the restorations tended to become discolored. She complained about the discoloration but she also complained about the occurrence of some yellow-white spots on her teeth as well. She wanted to improve the appearance of her smile. After the oral examination, she performed self- bleaching at home. An esthetic analysis and a diagnostic wax-up were conducted evaluate dental alignment and axis. Her left central incisor was set about 0.5mm wider than her right central incisor. We changed the line angle of left central incisor veneer to match that of the right central incisor. IPS e e.maxⓇPress, a pressed lithium-disilicate glass-ceramic, was used to cover the resin tooth due to its better physical properties and translucency. With enamel etching and porcelain surface treatment, the veneer was bonded well with the resin cement providing the bond strength.