Ó

Operative Dentistry, 0000, 00-0, 000-000

Ultrathin CAD-CAM Ceramic

Occlusal Veneers and Anterior
Bilaminar Veneers for the Treatment
of Moderate Dental Biocorrosion:
A 1.5-Year Follow-Up
TH Resende  KR Reis  LH Schlichting  P Magne

Clinical Relevance
Ultrathin bonded posterior occlusal veneers represent a conservative alternative to
traditional onlays and complete coverage crowns for the treatment of moderate and severe
erosive lesions.

SUMMARY damage of the remaining sound tooth struc-

ture. Ultrathin occlusal veneers are a conser-
Dental biocorrosion can produce a devastating
vative alternative to traditional onlays and
impact on oral health. The restorative phase of complete crowns for the treatment of severe
the treatment should not cause additional biocorrosive lesions. This strategy is explained
Tayane H Resende, MS, Analytical Laboratory of Restorative in the present case report through a full-mouth
Biomaterials - LABiom-R, School of Dentistry, Federal rehabilitation of a patient with moderate bio-
Fluminense University, Niterói, RJ, Brazil corrosion. Maxillary anterior teeth were re-
Kátia R Reis, DDS, MS, PhD, Department of Prosthodontics stored using the bilaminar technique (lingual
and Dental Materials, School of Dentistry, Federal Univer- direct composite veneers with labial ceramic
sity of Rio de Janeiro, Rio de Janeiro, RJ, Brazil veneers) and posterior teeth using ultrathin
*Luı́s H Schlichting, DDS, MS, PhD, Department of General CAD-CAM ceramic occlusal veneers. The tech-
Dentistry, School of Dental Medicine, East Carolina Univer- nical aspects required for the implementation
sity, Greenville, NC 27834, USA
of this new restorative design are presented
Pascal Magne, DMD, PhD, The Don & Sybil Harrington
with a special emphasis on the control of tooth
Professor of Esthetic Dentistry, Department of Restorative
Sciences, Ostrow School of Dentistry, University of Southern preparation based on diagnostic wax-up, pro-
California, Los Angeles, CA 90089, USA visionalization, and the use of CAD-CAM tech-
*Corresponding author: East Carolina University, General nology.
Dentistry, 1851 MacGregor Downs Rd., Mail Stop #701,
Greenville, NC 27834, USA; e-mail: luishschlichting@ INTRODUCTION
gmail.com
The dental enamel shell is designed to withstand a
DOI: 10.2341/17-007-T
lifetime,1 as witnessed in many patients in their 80s
 Operative Dentistry

and 90s who can still enjoy their teeth despite

obvious signs of wear and cracking. However, the
enamel thickness is reduced by dental biocorrosion.
By definition, the term ‘‘erosion’’ is a physical
mechanism, making the term ‘‘corrosion’’ more
appropriate for dental tissues. Likewise, the term
‘‘biocorrosion’’ differs from ‘‘corrosion’’ because the
prefix ‘‘bio-’’ designates chemical, biochemical, and
electrochemical actions on enamel and dentin.
Therefore, biocorrosion comprises endogenous and
exogenous acidic and proteolytic chemical degrada-
tion of enamel and dentin as well the electrochemical
piezoelectric action of the collagen in the dentin.2
Modern lifestyles have led many to poor eating
habits and dysfunctional behaviors that could ex-
plain the increase in prevalence of erosive lesions as
well as their severity.3 When experienced by young
individuals, the tissue loss in moderate and severe
cases of dental biocorrosion becomes problematic,
resulting in significant biological (sensitivity and
pulpal damage), esthetic, and functional consequenc-
es in addition to the complications due to the occlusal
changes (with or without loss of the vertical
dimension).4
Ultrathin occlusal veneers have been advocated as
a conservative alternative to ‘‘re-enamelize’’ the
occlusal surface compared to traditional overlays or
full coverage crowns.5,6 The intrinsic strength of
materials like lithium disilicate–reinforced glass
ceramics and high-performance composite resins,7-
12
combined with immediate dentin sealing,13-15
allows for thinner designs. It has been observed that
patients get motivated and encouraged when during
a treatment planning presentation they learn that
minimum or no additional reduction of tooth struc-
ture will be needed.
This article illustrates the application of these
concepts in a full-mouth rehabilitation of a patient
affected by moderate biocorrosion. In contrast with a
previous article16 where ultrathin CAD-CAM com- Figure 1. Preoperative views of a 28-year-old male patient with
posite resin occlusal veneers were utilized (Lava moderate to severe dental biocorrosion and wear. (A): ‘‘Visual tension’’
Ultimate, 3M ESPE, St Paul, MN, USA), this case can be perceived during smile due to biocorrosion/wear signs. (B-C):
Intraoral occlusal views display severe loss of enamel with higher
used a ceramic (e.max CAD, Ivoclar Vivadent AG, degree of destruction in the upper premolars and lower first and
Schaan, Liechtenstein). second lower molars.

CLINICAL TECHNIQUE REPORT

A 34-year-old man presented to the Department of lesions become apparent on facial surfaces as well as
Prosthodontics and Dental Materials at the Federal cupped cusp tips, thinned or inexistent enamel
University of Rio de Janeiro in 2015 requesting covering the occlusal perimeter, and restorations
treatment for dentin sensitivity and dental wear. standing above the level of the adjacent tooth
Intraoral evaluation revealed generalized dental structures (Figure 1A through 1C).
wear, including dentin exposure and clinical evi- Regarding the etiology, the hypothesis of intrinsic
dence of dental biocorrosion.3 Smooth and concave origin associated with gastroesophageal reflux dis-
Resende & Others: Ultrathin Occlusal Veneers

Figure 2. (A): Scannable stone replica of waxed cast with unaltered canines as repositioning reference. (B-C): Complete waxing (including canines,
mandibular incisal edges and mandibular third molars). (D-E): Scannable stone replica of the complete waxing were useful for anterior restorations
(mock-up, selective preparations, provisionals and enabled the use of the biogeneric copy tool).

ease could not be confirmed because of the dental CR was chosen. The vertical dimension of occlusion
wear pattern and patient medical history. However, (VDO) was arbitrarily augmented by 1 mm at the
the frequent consumption of acidic beverages (yerba incisal to allow space for the restoration on the
mate tea with lemon) may explain the severity in palatal aspect of the maxillary anterior teeth and to
this case. Furthermore, the presence of wear facets minimize the amount of preparation required for the
on the functional surfaces, such as the palatal and ultrathin occlusal veneers.16 A complete mouth
incisal edges of the maxillary and mandibular additive waxing was ordered (GEO Classic Mint-
incisors, suggests the combination of biocorrosion Opaque Wax, Renfert GmbH, Hilzingen, Germany)
and attrition disorder. The patient was immediately and carried out in two steps by the dental technician.
advised to control the intake of acid drinks and to First, all teeth planned to be restored (maxillary
use an occlusal guard to protect the teeth from arch: anteriors and premolars; mandibular arch:
mechanical wear. second premolars, first and second molars) were
additively waxed, except for the canines. Both waxed
The restorative treatment was set in two stages: models were then duplicated (Elite Double 32 Fast,
ultrathin CAD-CAM ceramic occlusal veneers on Zhermack, Badia Polesine, Italy) and poured with
selected posterior teeth and bilaminar veneers scannable stone (Snow Rock 3D Scan, Dk Mungyo
(direct composite resin on palatal and ceramic on Corp, Hanrim-myun Gimhae-si, Gyeongsangnam-do,
labial) on maxillary anterior teeth.17,18 Diagnostic South Korea) (Figure 2A). This step provided
casts (Pearl White GC Fujirock EP, GC America, technical accuracy for intraoral repositioning of
Alsip, IL, USA) were obtained from complete arch silicone guides for mock-up fabrication and provi-
polyvinyl siloxane impressions (Virtual, Ivoclar sional restorations and primarily enabled the use of
Vivadent). The bite was recorded at maximum the biogeneric copy in the software (CEREC inLab
intercuspal position (MIP), and casts were mounted v4.0.2, Sirona Dental Systems GmbH, Bensheim,
on a semiadjustable articulator. Centric relation Germany) to generate the definitive restorations.
(CR) was initially considered; however, MIP position Untouched canines and rearmost molars were
was utilized instead because the patient already had strategic for the correlation between the waxed
a retrognathic profile, which would be aggravated if models and the preparations. Then the technician
 Operative Dentistry

influence of the new VDO ( þ1 mm) in facial

appearance as well as muscular comfort was evalu-
ated for 15 days with splinted bonded provisional
acrylic restorations (Figure 3B,C).19 On the patient’s
approval, the provisional restorations were used as a
reduction guide for the preparations with tapered
diamond rotary instruments (product code
850.31.023 FG; Brasseler, USA). Depth cuts were
marked with a pencil. The remaining acrylic was
removed with an instrument, and preparation was
completed by reducing between the guide grooves
and erasing the pencil marks (Figure 4A,B). The
average occlusal clearance was 0.4 to 0.6 mm
(central groove) and 1.0 to 1.3 mm (cusp tips),
generating minimal space for ultrathin occlusal
veneers. After preparation, a rubber dam was
placed, and areas of exposed dentin were refreshed
with a coarse diamond bur at a maximum of 1500
rpm. Immediate dentin sealing (IDS) was achieved
using a three-step etch-and-rinse dentin bonding
agent (OptiBond FL, Kerr Corp, Orange, CA, USA)
(Figure 4C)13-15 according to the manufacturer’s
instructions. IDS was carried out without air
thinning of the adhesive and with an additional
light polymerization at 1000 mW/cm2 (Valo, Ultra-
dent Products Inc, South Jordan, UT, USA) for 10
seconds under an air barrier (K-Y Jelly, Johnson &
Johnson, New Brunswick, NJ, USA) to reduce the
oxygen inhibition layer. Excess adhesive resin and
irregularities were then removed from the surround-
ing enamel by using a round diamond rotary cutting
instrument (801.31.023 FG, Brasseler, USA) or
tapered burs (850.31.023 FG, Brasseler, USA) at
1500 rpm (Figure 4D). Among the most reliable
contemporary systems, OptiBond FL is especially
indicated for the application of IDS because of its
ability to form a consistent and uniform layer (about
80 lm when placed over a slightly convex dentin
Figure 3. (A): Spot etching on unprepared enamel previous to mock-
up fabrication. (B): Maxillary and mandibular mock-up (vertical
surface) and its cohesiveness with the final luting
dimension of occlusion increased by 1 mm). (C) Occlusal view of composite.
the posterior splinted provisional acrylic restorations.
The four posterior sextants were prepared and
restored over a period of 15 days (two per week;
maxillary arch first). In this regard, the additive
completed the waxing of the canines, lower incisal stone replicas (without the canine waxing) were
edges, and lower third molars (Figure 2B,C). The scanned first for correlation (Figure 5A) (Cerec AC
waxed models were duplicated and poured again Bluecam, Sirona Dental Systems) and then the
(Figure 2D,E). preparations (Figure 5B). A preview of the restor-
At the next appointment, mock-up restorations ative design was proposed after the correlation of the
were fabricated intraorally for esthetic and VDO models in the software (InLab v4.0.2, Sirona Dental
evaluation. Multispot etching on unprepared enamel Systems) (Figure 5C). Restorations were made
was carried out to increase the retention of provi- entirely in-house with the assistance of the design
sionals in poly(methyl methacrylate) resin (Dencôr tools of the software (InLab v4.0.2) set in Biogeneric
Lay, Clássico, São Paulo, Brazil) (Figure 3A). The Copy. The design was proposed by correlating the
Resende & Others: Ultrathin Occlusal Veneers

Figure 4. (A): Preparation driven by

provisional restorations. (B): Depth
cuts are marked with pencil, remain-
ing acrylic is removed, and prepara-
tion is completed when pencil marks
are erased. (C): Immediate dentin
sealing with a three-step etch-and-
rinse dentin bonding agent (Optibond
FL, NOT AIR-THINNED). (D): Remov-
al of excess adhesive from instru-
mented enamel.

preparations with the anatomy of the additive planned for restoration) in order to avoid early
waxing. Minimum editing was needed to obtain supraeruption, which could compromise the process
precise margins and ideal contact strength. The of correlation. Restorations were crystalized (Pro-
ultrathin occlusal veneers were milled from lithium gramat P300, Ivoclar Vivadent) and characterized
disilicate glass-ceramic blocks (A2 High Translucen- (stains mahogany, copper, and white IPS e.max
cy e.max CAD). The sprue was preferably located at CAD) and finally glazed.
the nonworking cusps: lingual (inferior arch) and At the following appointment, the ultrathin occlu-
buccal (superior arch). In the same appointment, the sal veneers were luted without the need for anes-
restorations were visually inspected to detect even- thesia. Provisionals were removed, and the prepara-
tual cracks and marginal chipping and, while in the tions were inspected for any remaining adhesive
precrystallized stage, tried in for occlusal contacts resin/acrylic resin. The conditioning of the restora-
and general fit (Figure 6A). tions included 10% hydrofluoric acid etching (Dents-
Due to the nonretentive geometry of the prepara- ply) for 20 seconds. After rinsing for 20 seconds, the
tion, provisionals were fabricated with some redun- restorations were subjected to postetching cleaning
dancy with respect to retention measures. The using 37.5% phosphoric acid (Ultra-Etch) under
surrounding occlusal enamel was spot etched with motion for one minute, followed by air-water spray
37.5% phosphoric acid (Ultra-Etch, Ultradent Prod- cleaning for 30 seconds. After air-drying, intaglio
ucts Inc, South Jordan, UT, USA) (Figure 6B) surfaces were silanated (Monobond Plus, Ivoclar
followed by coating protection of the previously Vivadent) and heat dried at 688C for around five
sealed dentin surfaces with a water-soluble separat- minutes (Calset, AdDent Inc, Danbury, CT, USA).
ing agent (Pro-V Coat, Bisco Dental Products, Under rubber dam, tooth preparations were
Schaumburg, IL, USA) (Figure 6C) in order to airborne-particle abraded with 50 lm aluminum
prevent potential resin bonding to the provisional oxide at 0.2 MPa and etched for 30 seconds with
poly(methyl methacrylate) resin (Dencôr Lay). The 37.5% phosphoric acid (Ultra-Etch), rinsed, and
polyvinyl siloxane indexes (Platinum 85, Zhermack) dried. Both fitting surfaces, restoration and tooth,
were then loaded with the acrylic resin (Dencôr Lay) were coated with adhesive resin (Optibond FL,
and precisely repositioned (Figure 6D). Provisionals Bottle No. 2) and left unpolymerized until the
were not retrieved, and excesses on the embrasures preheated luting material (Z100, 3M ESPE) (pre-
were purposely left in order to provide extra heated at 688C with Calset, Adent) was applied to
retention. Mandibular third molars were provision- the tooth.20 The restorations were seated (the entire
alized during all restorative phases (although not sextant) followed by careful elimination of gross
 Operative Dentistry

margins were finished and polished at the following

appointment first with silicon-impregnated rubber
polishers (Jiffy, Ultradent) and, in case of minor
horizontal discrepancy, with diamond ceramic pol-
ishers (W16Dg, W16Dmf, and W16D, EVE Diapol,
EVE Ernst Vetter GmbH, Pforzheim, Germany). At
this clinical stage, after MIP stabilization, the
mandibular third molar provisionals were removed,
allowing supraeruption and intercuspation of these
teeth according to the Dahl principle.17
The anterior maxillary sextant was restored in the
most conservative way: according to the bilaminar
approach.18 The palatal surface of the six teeth was
rebuilt with direct composite under rubber dam
isolation (including clamp #212). Preparation was
limited to the refreshing of the exposed dentin with a
diamond bur at low speed (1500 rpm). After the
application of a total-etch dental adhesive (Optibond
FL), the marginal ridges, cingulum, and palatal
fossa were recovered with freehand composite resin
application (Empress Direct, Ivoclar Vivadent, Fig-
ure 8A). If ceramic had been chosen, additional
preparation of the palatal surface would have been
needed. In the following two appointments, anterior
teeth were prepared (Figure 8B), and monolithic
stained CAD-CAM lithium disilicate–reinforced
glass ceramic (e.max CAD) was fabricated (Figure
8C) and luted (Variolink Veneer, Ivoclar Vivadent).
Finally, the incisal edges of the mandibular anterior
teeth were restored with direct composite resin (IPS
Empress Direct).

DISCUSSION
It is notable how well patients presenting with
moderate to severe loss of tooth structure due to
biocorrosion react when minimally invasive recon-
structive approaches are proposed to them. Both
biological and economic costs are significantly lower
compared to traditional and more aggressive options,
Figure 5. (A): Scanning of wax-up replica. (B): Powdering of
making the decision-making process easier and the
prepared teeth. (C): Preview of the restorative design after the acceptance rate higher. The diagnostic wax-up and
correlation of the models. Note the excellent overlap between the wax- mock-up play a key role in this matter, helping both
up and prepared teeth.
patient and clinician assess the physical aspects of
the proposal as well as in the following technical
steps of the work flow. Despite the fact that digital
excess composite resin and initial light polymeriza- design along with the possibility of 3D printing is
tion.21 Each surface was exposed at an irradiance of already available, the wax-up was delegated to a
1000 mW/cm2 (Valo, Ultradent) for 60 seconds (20 skilled technician and performed in the traditional
seconds per surface repeated three times). All additive way.
margins were then covered with an air barrier (K- The option of using the mock-up for a period of
Y Jelly,) and light polymerized for 10 seconds. time (in the present case, two weeks) provides a good
Occlusal adjustments were minor due to the adjust- level of predictability, mainly when the VDO is
ments in the precrystallized stage (Figure 7). The augmented. Based on the study of Abduo,19 the
Resende & Others: Ultrathin Occlusal Veneers

Figure 6. (A): Try-in of ultrathin

occlusal veneers in blue phase. (B):
Spot etching of prepared enamel with
37.5% phosphoric acid provides extra
retention for provisional restorations.
(C): Separating agent (Pro V Coat) for
selective retention of provisional. (D):
Provisional splinted restoration still
showing the excesses to be removed.

Figure 7. Luting completed in man-

dibular right posterior sextant.

option of using the mock-up for two weeks provided a

good level of acceptance with the VDO augmented in
only 1 mm. Considering the two additional weeks to
deliver the occlusal veneers, the total time of
provisionalization was one month. Acrylic resin is
the material of choice for provisionals because of its
good fracture resistance compared to the bis-acryl
resins, which is critical for ultrathin restorations.
Additionally, one of its drawbacks (the high poly-
merization shrinkage) can be an advantage since it
will help to keep the provisional locked. Having the
confirmation of occlusal comfort, the same mock-up
is used as a reference guide for an accurate
preparation.
Regarding the bonding strategy, Optibond FL was
the first choice for immediate dentin sealing. Its
filler content allows for a more consistent and
uniform layer compared to unfilled systems. This
feature also decreases the chances of dentin expo-
sure during cleaning and roughening procedures at
the delivery appointment.15 It was also used along
with the direct composite because of the intrinsic
advantages of a fourth-generation system and also in
order to simplify the process using one system for all
purposes.
The choice of a preheated traditional light-poly-
merizing composite resin as a luting agent is
supported by clinical22-24 and laboratory evidence25
as well as by practical advantages: unlimited
working time (compensating for the difficulty of
positioning the occlusal veneers because of the lack
of insertion path), less formation of interfacial voids
because of the low viscosity,26 ideal consistency for
seating and excess removal, and better mechanical
properties because of the higher filler content and
Figure 8. (A): Palatal direct veneers (freehand composite, Empress
higher degree of conversion.1,20 In addition, preheat- Direct). (B): Facial veneer preparations. (C): Lithium disilicate veneers
ed composite reached a high degree of conversion after staining/glazing.
 Operative Dentistry

using low radiant exposures, between 50% to 70%,

compared to composite polymerized at room temper-
ature.27
When investigating the material to fabricate
ultrathin occlusal veneers, both ceramic and com-
posites were able to meet the requirements for
mechanics, function, and esthetics under an in vitro
accelerated fatigue study5 that was validated by
numeric simulation.6 However, CAD-CAM compos-
ite resins may provide better fracture resistance
under extreme load conditions.5 In these patients, it
is highly recommended to use an occlusal splint
regardless of the restorative material. Further
research is required to assess the clinical perfor-
mance of those novel-design ultrathin occlusal
veneers. For this reason, the case presented here is
part of a comprehensive clinical trial ongoing at the
Dental School of the Federal University of Rio de
Janeiro. Patients affected by moderate to severe
biocorrosion are being randomly treated with this
novel design using two different CAD-CAM materi-
als (composite resin and ceramic).

Clinical Follow-Up
The intraoral aspects of the patient can be observed
before treatment (Figure 1A through 1C), after
treatment completion (Figure 9A through 9E), and
after 1.5 years of treatment (Figure 10A through
10D).

CONCLUSIONS
This case report demonstrates the feasibility of
restoring the dental sequelae of moderate biocorro-
sion with ultrathin CAD-CAM ultrathin occlusal
veneers and anterior bilaminar veneers. The treat-
ment was successful due to the conservation of the
dental tissue, esthetics, and effectiveness to restore
dental wear caused by biocorrosion confirmed by the
reevaluation after 1.5 years of clinical service,
although it has been observed that addressing the
etiologic factor along with the use of an occlusal
splint (when associated to attrition) is of paramount
importance.

Acknowledgements
The authors wish to express their gratitude to FAPERJ for the
research grant E-26/112.046/2012; the Federal University of
Rio de Janeiro for the inLab MC XL milling unit; Dr. Silvana
Marques Miranda Spyrides (chair, Department of Prostho-
dontics and Dental Materials, School of Dentistry, Federal
Figure 9. Right (A) sextant in occlusion. Occlusal views of the University of Rio de Janeiro) for her support on building the
completed restorations (B,C). Patient’s smile after treatment conclu- new CAD-CAM laboratory as well as the buying process of the
sion (D). milling unit MCXL through the university; Sirona Brazil for
the discount for the Cerec System and for the Hugo stool; Mr
Resende & Others: Ultrathin Occlusal Veneers

Figure 10. 1.5-year follow-up. (A): Restorations well integrated in the smile. (B) Palatal view of the anterior teeth. Note the subtle blending between
composite - ceramic. (C-D): Lower posterior teeth (no signs of cracks or chipping in the restorations).

Holger Kappler (Kappler) for the discount on the Cerec MCXL or kind in any product, service, and/or company that is
cabinet; Mr Herbert Mendes and Dr Camila Madruga (Ivoclar presented in this article.
Vivadent) for the Variolink Veneer Kit and Empress Direct
and also for the discount on IPS e.max CAD blocks and the
Programat P300 oven and other dental materials from Ivoclar; (Accepted 5 August 2017)
Mr Rodrigo Negreiros (3M ESPE) for Protemp 4; Dr Joshua
Friedman (AdDent) for Calset and Microlux; Dr Byoung Suh REFERENCES
(Bisco Dental Products) for Pro-V Coat; Dr Richard Tuttle
(Ultradent) for Ultra-Etch, Ultrapak, Opalescence 10%, Jiffy 1. Magne P & Belser U (2002) Bonded Porcelain Restora-
Kit; Ms Leigh Anne Jones (territory manager, Kerr Restor- tions in the Anterior Dentition: A Biomimetic Approach
atives) for Optibond FL and Kolor þ Plus; Dr Gabriela Lomeu Quintessence Publishing, Chicago.
for assisting during the restoration of the anterior maxillary
teeth; and Mr Arno Egon Gressler (Dental Design - Caxias do 2. Grippo JO (2012) Biocorrosion vs. erosion: The 21st
Sul, Brazil) for the diagnostic wax-up. This work was century and a time to change. Compendium of Continuing
supported by grant E-26/112.046/2012 from FAPERJ (Carlos Education in Dentistry 33(2) e33-e37.
Chagas Filho Foundation for the Support of Research in the
State of Rio de Janeiro). 3. Lussi A, Hellwig E, Ganss C, & Jaeggi T (2009) Buonocore
memorial lecture. Dental erosion Operative Dentistry
Regulatory Statement 34(3) 251-262.
This study was conducted in accordance with all the 4. Barron RP, Carmichael RP, Marcon MA, & Sàndor GK
provisions of the local human subjects oversight committee
(2003) Dental erosion in gastroesophageal reflux disease
guidelines and policies of the Universidade Federal do Rio de
Janeiro. Journal of the Canadian Dental Association 69(2) 84-89.
5. Schlichting LH, Maia HP, Baratieri LN, & Magne P (2011)
Conflict of Interest Novel-design ultra-thin CAD/CAM composite resin and
The authors of this article certify that they have no ceramic occlusal veneers for the treatment of severe dental
proprietary, financial, or other personal interest of any nature erosion Journal of Prosthetic Dentistry 105(4) 217-226.
 Operative Dentistry

6. Magne P, Stanley K, & Schlichting LH (2012) Modeling of veneers: A clinical report Journal of Prosthetic Dentistry
ultrathin occlusal veneers Dental Materials 28(7) 116(4) 474-482.
777-782.
17. Magne P, Magne M, & Belser UC (2007) Adhesive
7. Tinschert J, Natt G, Mautsch W, Augthun M, & restorations, centric relation, and the Dahl principle:
Spiekermann H (2001) Fracture resistance of lithium Minimally invasive approaches to localized anterior tooth
disilicate-, alumina-, and zirconia based three-unit fixed erosion European Journal of Esthetic Dentistry 2(3)
partial dentures: A laboratory study International Jour- 260-273.
nal of Prosthodontics 14(3) 231-238.
18. Vailati F, & Belser UC (2011) Palatal and facial veneers
8. Beuer F, Schweiger J, & Edelhoff D (2008) Digital to treat severe dental erosion: A case report following the
dentistry: An overview of recent developments for CAD/ three-step technique and the sandwich approach Europe-
CAM generated restorations British Dental Journal an Journal of Esthetic Dentistry 6(3) 268-278.
204(9) 505-511.
19. Abduo J (2012) Safety of increasing vertical dimension of
9. Leinfelder KF (2001) Ask the expert. Will ceramic occlusion: A systematic review Quintessence Internation-
restorations be challenged in the future? Journal of the al 43(5) 369-379.
American Dental Association 132(1) 46-47.
20. Daronch M, Rueggeberg FA, De Goes MF, & Giudici R.
10. Manhart J, Chen H, Hamm G, & Hickel R (2004) (2006) Polymerization kinetics of pre-heated composite
Buonocore memorial lecture. Review of the clinical Journal of Dental Research 85(1) 38-43.
survival of direct and indirect restorations in posterior
teeth of the permanent dentition Operative Dentistry 21. Wilson PR (1996) Low force cementation Journal of
29(5) 481-508. Dentistry 24(4) 269-273.

11. Leinfelder KF (2005) Indirect posterior composite resins 22. Krämer N, & Frankenberger R. (2000) Leucite-reinforced
Compendium of Continuing Education in Dentistry 26(7) glass ceramic inlays after six years: Wear of luting
495-503. composites Operative Dentistry 25(6) 466-472.

12. Spreafico RC, Krejci I, & Dietschi D (2005) Clinical 23. Schulte AG, Vöckler A, & Reinhardt R. (2005) Longevity
performance and marginal adaptation of class II direct of ceramic inlays and onlays luted with a solely light-
and semidirect composite restorations over 3.5 years in curing composite resin Journal of Dentistry 33(5)
vivo Journal of Dentistry 33(6) 499-507. 433-442.
13. Magne P, & Douglas WH (1999) Porcelain veneers: 24. Krämer N, & Frankenberger R. (2005) Clinical perfor-
Dentin bonding optimization and biomimetic recovery of mance of bonded leucite-reinforced glass ceramic inlays
the crown International Journal of Prosthodontics 12(2) and onlays after eight years Dental Materials 21(3)
111-121. 262-271.
14. Dietschi D, Monasevic M, Krejci I, & Davidson C (2002) 25. Goldberg J, Güth JF, & Magne P. (2016) Accelerated
Marginal and internal adaptation of class II restorations Fatigue Resistance of Thick CAD/CAM Composite Resin
after immediate or delayed composite placement Journal Overlays Bonded with Light- and Dual-polymerizing
of Dentistry 30(5-6) 259-269. Luting Resins Journal of Adhesive Dentistry 18(4) 341-348.
15. Magne P (2005) Immediate dentin sealing: A fundamen- 26. Lee JH, Um CM, & Lee IB (2006) Rheological properties
tal procedure for indirect bonded restorations Journal of of resin composites according to variations in monomer
Esthetic and Restorative Dentistry 17(3) 144-154. and filler composition Dental Materials 22(6) 515-526.
16. Schlichting LH, Resende TH, Reis KR, & Magne P (2016) 27. Daronch M, Rueggeberg FA, De Goes MF, & Giudici R.
Treatment of severe dental erosion with ultra-thin CAD/ (2006) Polymerization kinetics of pre-heated composite
CAM composite occlusal veneers and anterior bilaminar Journal of Dental Research 85(1) 38-43.