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Direct Aesthetic Restorations

Dentist Ingrida Ivance is a laureate of Lithuanian and International Direct Aesthetic Restorative Dentistry contests of the year 2000; General Member of American Academy of Cosmetic Dentistry.
(about Academy)

Here we will introduce you with one of aesthetic dentistry areas – direct aestethic restoration. Often direct aestethic restorations are named aesthetic fillings.

About Beautiful Smile
About Direct Aesthetic Restorations
In what Cases Direct Aesthetic Restorations are Used
Why to Choose Direct Aesthetic Restoration Procedure at VivaDens?
Responses of Clients
Photo Album of Direct Aesthetic Restorations
Harmonization of Procedures

About Beautiful Smile

Scientific study performed in USA1proved that with a beautiful smile an individual becomes not only more attractive, but looks healthier, more intelligent, interesting and successful.

99.7 % of respondents of this survey stated that a beautiful smile is an important social asset, 96 % - that beautiful makes a person more appealing to people of the opposite sex, 74 % - that unattractive smile reduces chances for career success. Answers of respondents to the question "What is the first thing you notice in person’s smile?" are given below:

  • Straightness of teeth
  • Color
  • Cleanliness of teeth
  • Sincerity of the smile
  • Any missing tooth
  • "Sparkle" of the smile.

Answering the question "What types of things do you consider make a smile unattractive?" they noted:

  • Yellow, discolored, stained teeth
  • Missing tooth
  • Crooked tooth
  • Decaying teeth, cavities
  • Gaps and spaces in teeth
  • Dirty teeth.

Finally, the most common answer to the question "What would you like to improve about your smile?" was

  • I would like whiter and brighter teeth.

In other survey performed in USA2, the respondents to a question "What was the last dental procedure you had within the last month?" responded as follows: 86 % - direct aesthetic restoration; 78 % - teeth whitening at home; 55 % - placing porcelain veneers over teeth, 50 % - in-office teeth whitening, 25 % - gingival recontouring.

Therefore, the numbers demonstrate that direct aesthetic restoration is the most extensively prevailing procedure in USA. Pioneers of aesthetic dentistry also assert that: "Without hesitation direct aesthetic restoration will continue to be the major esthetic restorative procedure". Gordon J.Christensen, DDS, MSD, Ph.D. The Journal of Cosmetic Dentistry, 2003, Vol. 19 (USA).

Authorities of the western dentistry community affirm that today a minimal invasion is necessary: "Our goal should be continuous preservation more of what that remains, than meticulous restoration of what is missing. Thus, the best dentistry is minimum invasive dentistry". (Source:  "Journal of Esthetic and Restorative Dentistry 2008, Vol. 20, N6"). Meantime direct aesthetic restoration remains the most preserving teeth restoration method.

About Direct Aesthetic Restorations

Material used to make aesthetic fillings or direct aesthetic restorations is called composite or popularly – "aesthetic filling". Missing dentine and enamel are recreated with it. By its strength the composite equals to amalgam fillings, it is resistant to wear, releases fluoride preventing from further formation of caries lesions.

Direct aesthetic restoration we offer at VivaDens center is one of the most preserving methods of teeth restoration. When making direct aesthetic restoration natural tooth tissues are preserved to the maximum, deep cut preparation is not needed, teeth remain alive, gingiva is not damaged, natural teeth layers are recreated, their translucency and form. Natural tooth is an optimal substance guaranteeing stability, resistance and compatibility with surrounding gingiva and bone structure.

Direct aesthetic restorations are done with the precision of fine jeweler, biomimeticly – layer by layer – exactly the same way as teeth tissues developed during evolution, the small details and depth of color are imitated. Usually clients are very satisfied, because that it the most preserving tooth structure restoration method.


In what Cases Direct Aesthetic Restorations are Used

Direct aesthetic restoration: properly matched composite color.
Photo 1: dentist I.Ivance ©, DDS

In Lithuania dentists restore the teeth with composites made in Japan, USA, Germany, i.e. completely with the same materials which are used by their colleagues from the progressive Western countries.

The composites differ among themselves the by certain parameters, for instance, color, reflection coefficient, elasticity module, i.e. capacity to deform along axis, polishing characteristics and similarly. Therefore, for teeth restoration the skilled dentist shall select various composites in accordance with different clinical situation.

The scale of composite colors is very wide, thus it is possible very naturally to imitate missing tooth tissue (See Photo 1).

Direct aesthetic restoration: form changing.
Photo 2: dentist I.Ivance ©, DDS

With composites it is possible to recreate or beautify a tooth form (See Photo 2). Deep cut preparation is not used, thus teeth remain vital. Gingiva is not damaged. Restoration is done by recreating teeth layers, their translucency, form and functions. After procedure teeth look very naturally, often even professionals do not notice a restored tooth.

Direct aesthetic restoration: restored incisal edges of teeth.
Photo 3: dentist I.Ivance ©, DDS

Having enamel of teeth incisal edge worn, dentin is exposed, a tooth tissue that is five times softer, and then wearing accelerates. It is possible to notice in the mouths of elder people that due to substantial wear the teeth look as if "cut-off". It is possible and even necessary to restore worn incisal edges with composites (See Photo 3). That is healthier and also more functional, and more aesthetic.

Direct aesthetic restoration
Photo 4: dentist I.Ivance ©, DDS

Entire tooth front surface may be covered with composites to restore or cover teeth form and color changes, i.e. so named direct laminate or veneer is placed. Indirect (i.e. made in laboratory) porcelain (ceramic) veneers are used for the same purpose..

Direct aesthetic restoration: closed "black triangles" near gingiva
Photo 5: dentist I.Ivance ©, DDS

Having supporting bone loss, teeth necks are exposed and so named "black triangles" become visible near gingiva. Professional aesthetic restoration is also helpful much in this case, because transparent black gaps near gingiva are closed. (Photo 5)

Direct aesthetic restoration: changing of irregular position of six front teeth.
Photo 6: dentist I.Ivance ©, DDS

In case of irregular teeth position, first of all orthodontic treatment with braces is recommended that is also more correct medically, because this way natural, own teeth are completely preserved.

However, some clients refuse such usually rather long time taking orthodontic treatment (for instance due to profession, going to other country, forthcoming marriage, etc.). Then it is possible with aesthetic fillings even to "straighten" a teeth that are positioned irregularly (Photo 6). In this case teeth tissues situated in undesirable position are removed by deep-cut preparation, and missing ones – imitated with composite.

Direct aesthetic restoration: gap closing and form changing.
Photo 7: dentist I.Ivance ©, DDS

When creating a tooth structure, which is characteristic to specific individual, with restoration materials, the color that is identical to other teeth is chosen and also multilayer view that is characteristic to other teeth is created. Already during one visit that lasts from 4 to 6 work hours, it is possible to restore four teeth, for instance, to fill gaps between front teeth (Photo 7).

A tooth to be restored is harmonized with nearby present teeth and this way symmetry is created considering the same tooth which has grown on the opposite side. 

Direct aesthetic restoration of molars.
Photo 8: dentist I.Ivance ©, DDS

Direct aesthetic restoration is suitable not only for front teeth, but also for lateral and back group of teeth (Photo 8).

Why to Choose Direct Aesthetic Restoration Procedure at VivaDens?

If you are looking for professionalism and world level quality of direct aesthetic restorations - visit VivaDens. Here professional dentists of the highest and very high qualification in aesthetic restorations are employed, laureates and finalists of Lithuanian and international competitions in the art of direct aesthetic restorations. Dentist Ingrida Ivance (Ivanciute), is the initiator of direct aesthetic restorations in Lithuania, already for more than ten years organizes and leads professional development courses for dentists; from her the best Lithuanian specialists in aesthetic restoration were learning. From more than 10 years of its experience VivaDens knows where direct aesthetic restoration is the most suitable and where aesthetic prosthesis (indirect aesthetic restorations) with veneers or crowns, etc. would suite more and could be recommended. Including the needs of client we harmonize direct aesthetic restorations with indirect aesthetic restorations in a team work of qualified specialists. Each dentist has photo examples of his/her works that would allow you to understand better the possibilities of direct and indirect aesthetic restorations and choose the dentist. After procedure in front teeth area you will also receive your teeth photos "before and after". Besides, the most modern and safest medical equipment (laser, microscope, digital spectrophotometer, etc.) and exceptionally qualified dentist assistants guarantee the good result at the maximum.

The Main Pluses of Direct Aesthetic Restorations

  • Very aesthetic, natural, warm appearance of  restorations (that is often missing in teeth prosthesis)
  • Usually fewer teeth tissues are removed than in teeth prosthesis
  • Strengthens teeth
  • Fast solution (in one, several visits)
  • Especially suitable for children, young people in case of teeth fractures
  • In some cases may be as alternative to orthodontic treatment (braces, etc.), prosthesis
  • Laboratory procedures are not needed (time, finances are saved)
  • Having the restoration fractured it is usually easy to correct it in one visit

The Main Minuses of Direct Aesthetic Restorations

  • Composites shrink (1.2 - 3.5%) when polymerized (hardened with halogen lamp) – due to that over the time marginal integrity may be lost, permeability and coloring develop
  • Composites match optical and physical characteristics of dentin, but not enamel, thus composites suit the best for dentin restorations only and ceramic (porcelain) restorations would match enamel.
  • Composites accumulate plaque more, thus it is advised to polish restorations during annual professional oral hygiene visit
  • Aesthetic and good quality restorations require experience, professionalism and talent from dentist.


Video about direct aesthetic restoration, indirect aesthetic restoration (prosthesis) and their harmonization (in Lithuanian language) (WMV, 6 min, 0 MB)

Responses of Clients

Photo Album of Direct Aesthetic Restorations

Harmonization of Procedures

The best case is when teeth and oral cavity are treated in entirety – starting from professional oral hygiene, teeth whitening, if needed, aligning teeth with braces, treating teeth root canals, gingiva, placing implants, making dental prosthesis, harmonizing dental prosthesis with fillings, etc. Only then we may rejoice together in teeth functionality and aesthetics as well as in a long term result.

And to smile miraculously!


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Aesthetic Dentistry Center VivaDens

51-70 Didlaukio Str. (entry from Ateities Str.)   |   LT-08303 Vilnius, Lithuania, EU   |     phone: 370-5-2627990,   370-5-2675404
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We are thankful for all VivaDens clients who kindly allowed us to use their face, teeth and smile photos on our website. It makes clients' search and decision process much easier and faster. Let's create and share together. Thank you sincerely.