"Aesthetic Transformation of Fluorosed Teeth Using Minimally Invasive Direct Composite Veneers: A Case Report”
Abstract
ABSTRACT
Minimally invasive esthetic dentistry has increased the use of direct composite veneers as a conservative alternative to ceramic restorations for managing anterior discolorations. Dental fluorosis, resulting from excessive fluoride intake during enamel formation, commonly produces frosty white and yellowish-brown stains and surface irregularities that compromise smile esthetics and patient confidence. This case report presents the esthetic management of moderate dental fluorosis using direct composite veneers completed in a single visit. Treatment involved shade selection with the composite button technique, minimal enamel preparation restricted to stained areas, bonding with a self-etch adhesive, and restoration with a nanohybrid composite resin using a polychromatic incremental layering approach to simulate natural dentin–enamel optics. Finishing and polishing with sequential disc systems yielded smooth, glossy surfaces with excellent shade integration and anatomy. The outcome demonstrates that, with appropriate case selection and careful execution, direct composite veneers offer a predictable, conservative, and cost-effective solution for anterior teeth affected by moderate fluorosis.
References
2. Rathee M, Divakar S, Jain P, Chahal S, Singh S. Anterior esthetic rehabilitation with full and partial veneers using conventional and digital techniques: A case series. J Conserv Dent Endod 2023;26:601 7.
3. Yanıkoğlu F, Günday M. Direct composite laminate veneers: three case reports. J Dent Res Dent Clin Dent Prospects. 2013;7(2):105–11.
4. Korkut B. Smile makeover with direct composite veneers: a two-year follow-up report. J Dent Res Dent Clin Dent Prospects. 2018;12(2):146–51.
5. Sowmya K, Dwijendra KS, Pranitha V, Roy KK. Esthetic Rehabilitation with Direct Composite Veneering: A Report of 2 Cases. Case Reports in Dentistry. 2017;1–3.
6. Harshita, V Asit, S Neha, KV Vijay, B Nikhil. Esthetic rehabilitation with direct composite veneering-two case reports. International Journal of Applied Dental Sciences. 2022;8(4):178-80.
7. Değirmenci A, Balousha JK, Pehlivan İE. Aesthetic rehabilitation for anterior teeth of dental fluorosis with direct composite veneers. Niger J Clin Pract 2023;26:1211 4.
8. Kohn WG, Maas WR, Malvitz DM, Presson SM, Shaddix KK. Recommendations for using fluoride to prevent and control dental caries in the United States. MMWR Recomm Rep. 2001;50(RR-14):1–42.
9. Abanto Alvarez J, Rezende KM, Marocho SM, Alves FB, Celiberti P, Ciamponi AL. Dental fluorosis: exposure, prevention and management. Med Oral Patol Oral Cir Bucal. 2009 1;14(2):E103-7.
10. Bhagavatula P, Levy SM, Broffitt B, Weber-Gasparoni K, Warren JJ. Timing of fluoride intake and dental fluorosis on late-erupting permanent teeth. Community Dent Oral Epidemiol. 2016;44(1):32–45.
11. Den Besten PK. Mechanism and timing of fluoride effects on developing enamel. J Public Health Dent. 1999;59(4):247–51.
12. Sundfeld RH, Sundfeld-Neto D, Machado LS, Franco LM, Fagundes TC, Briso ALF. Microabrasion in tooth enamel discoloration defects: three cases with long-term follow-ups. J Appl Oral Sci. 2014;22(4):347–54.
13. Cavalli V, Rosa DAD, Silva DPD, Kury M, Liporoni PCS, Soares LES, Martins AA. Effects of experimental bleaching agents on the mineral content of sound and demineralized enamels. J Appl Oral Sci. 2018:26.
14. Ricci WA, Fahl N Jr. Nature-mimicking layering with composite resins through a bio-inspired analysis: 25 years of the polychromatic technique. J Esthet Restor Dent. 2023;35(1):7–18.
15. Soares PM, Chiapinotto GF, Abreu DDS, Pereira GKR. Masking discolored substrates with resin composites: effect of layering strategies. Braz Dent J. 2024;35:e245910.
16. Mackenzie L, Parmar D, Shortall A, Burke FJT. Direct anterior composites: a practical guide. Dent Update. 2013;40(4):297–317.
17. Negucioiu M, Rusnac ME, Dosa R, Kui A, Fluerașu M, Buduru S. Composite layering techniques in direct anterior restorations: a scoping review on longevity and clinical outcomes. Rom J Oral Rehabil. 2025;17(2):52–64.
18. Saisho H, Pontons-Melo JC, Vargas M. Direct anterior resin composite restorations: an update on esthetic techniques. Int Dent Afr Ed. 2024;14(2):12–18
19. Villarroel M, Fahl N, De Sousa AM, De Oliveira OB Jr. Direct esthetic restorations based on translucency and opacity of composite resins. J Esthet Restor Dent. 2011;23(2):73–87.
