Esthetic applications of restorative materials and techniques in the anterior dentition.

The esthetic expectations of our patients can be met by doing a thorough initial examination with emphasis on periodontal health, caries incidence, occlusion, possible orthodontic corrections, esthetic needs, and economic concerns. Through proper communication with the patient, a written treatment plan can be developed that uses the various techniques of bleaching, cosmetic recontouring, direct resin bonding, porcelain veneering, or crowning to meet the patient's restorative needs. The most conservative noninvasive techniques should be evaluated first. Often, bleaching and partial direct bonding are all that is needed. If the dentition is badly worn or discolored, then more extensive treatment is indicated. Patients frequently have concerns about longevity of restorations or require very high levels of esthetic correction, which can only be accomplished with more invasive techniques. When patients understand what can be accomplished and are involved in the treatment decision, then successful results are assured. Esthetic restorative dentistry is probably the most rewarding aspect of practice today, but it is also the most challenging. New materials appear and techniques change so rapidly that it is sometimes difficult to keep up. Practitioners should acquire a thorough knowledge of available methods and materials, learn the limitations of these materials and techniques, and master skills through continuing education (courses, journals, and newsletters) as well as chairside repetition as new procedures become available.