An Esthetic Challenge: Case Report Utilizing a Combination of Monolithic Ceramic Veneers and Porcelain Fused to Metal Crown

Introduction Restorative dentistry is the art and science of replacing human tooth structure. It has been said that individually, enamel and dentin are lowstrength materials but when combined, have a unique bond that can last a lifetime [1]. Finding the perfect dental material to mimic nature's bioengineering through the years has emerged from a monolithic metal design to a bi-layered metal-ceramic or polycrystalline-ceramic design and then to monolithic ceramic design.1 The success of an esthetic rehabilitation not only depends on the material selection or the lab utilized but more importantly, understanding how to work with the unique characteristics of different restorative materials to achieve a predictable, functional and beautiful outcome for each individual case. Purpose The purpose of this case report is to describe a treatment modality utilizing two different restorative materials in the smile zone to achieve an acceptable esthetic outcome. Monolithic pressed lithium disilicate and porcelain fused to high noble metal were the restorative materials utilized. Case Description A 48-year-old Hispanic male presents to the dental clinic with a chief complaint of discoloration and cracks existing on his 16-year-old veneers. Examination revealed 5 discolored veneers with several areas of wear and crack propagation and an existing crown with recurrent decay. Recession of his anterior teeth displayed the margins of his existing restorations. He was unhappy with his smile and wanted a smile makeover that would appear whiter than his existing veneers and appear as natural as possible. Conclusion Restoration of a pleasant smile by successfully matching two different materials in the smile zone was achieved to the patent's satisfaction.