title: Integration of composite and ceramic restorations in tetracycline-bleached teeth: a case report.
abstract: The success of an esthetic rehabilitation depends on the understanding of the patient's need and expectation. The management of patients with moderate to severe tetracycline-stained teeth is very challenging. Tooth whitening may be a valid alternative to more aggressive treatments; however, patients should be aware of the limitations of tooth whitening therapy. Clinicians may select differing treatment plans; tooth whitening can improve intrinsic discoloration in a way so that no further treatment is required. Once tooth whitening is completed, direct or indirect restorative procedures may be afforded to match the existing restoration with the bleached tooth structure. This article describes a conservative clinical approach to rehabilitate the smile of a patient with moderate to severe tetracycline-stained teeth using a combination of tooth whitening and direct composite and indirect porcelain restorations in the maxillary anterior segment.
  
  
  CONCLUSIONS
  The combination of tooth whitening and adhesive restorations allows clinicians a significantly more conservative approach to intrinsically stained teeth; tooth preparation for porcelain veneers and porcelain-fused-to-metal and full-ceramic crowns can be restricted to conditions in which persistent tooth discoloration or significant loss of both dentin and enamel exists.
authors.affiliation: Tufts University School of Dental Medicine, Boston, MA, USA. simone.deliperi@tufts.edu
authors.forename: Simone
authors.initials: S
authors.lastname: Deliperi
authors.forename: M Debora
authors.initials: MD
authors.lastname: Congiu
authors.forename: David N
authors.initials: DN
authors.lastname: Bardwell
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D003188:Composite Resins; D003442:Crowns; D001840:Dental Bonding / Q000379:methods*; D003776:Dental Porcelain; D003793:Dental Restoration, Permanent / Q000379:methods*; D005260:Female; D005899:Glass Ionomer Cements; D006801:Humans; D019279:Resin Cements; D013752:Tetracycline / Q000009:adverse effects; D014073:Tooth Bleaching; D014075:Tooth Discoloration / Q000139:chemically induced / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents; D003188:Composite Resins; D005899:Glass Ionomer Cements; D019279:Resin Cements; D003776:Dental Porcelain; D013752:Tetracycline