Utilizing Direct Posterior Composite Onlays Sandra Hulac, DDS, AAACD This deck describes a method of opening posterior vertical dimension using direct composite onlays as transitional restorations, allowing a full-mouth rehabilitation to be provided segmentally. Restoring anterior wear presents the practitioner with a variety of challenges: A firm diagnosis of the wear etiology must be established to formulate the correct treatment plan.

1. Opening Vertical Dimension for
Esthetic Treatment
Utilizing Direct Posterior Composite Onlays
Sandra Hulac, DDS, AAACD

2. Abstract
This deck describes a method of opening posterior vertical dimension using direct
composite onlays as transitional restorations, allowing a full-mouth rehabilitation
to be provided segmentally.
Restoring anterior wear presents the practitioner with a variety of challenges: A firm
diagnosis of the wear etiology must be established to formulate the correct
treatment plan.
Adapted from the full article, which originally appeared in the AACD’s
Journal of Cosmetic Dentistry, Fall, 2013 issue.
For more information, visit www.AACD.com.
© 2015 American Academy of Cosmetic Dentistry, All Rights Reserved

3. Palatal view of upper anterior before treatment;
palatal surfaces are covered with composite
resin.
Full smile at initial appointment; #8 is
fractured.

4. Upper arch before treatment. Lower arch before treatment.

5. Upper anteriors before treatment; tissue
profile is indicative of overeruption of
centrals.
Kois deprogrammer at review appointment.

6. Cephalometric radiograph. Full-face smile before treatment.

7. Preoperative right smile. Preoperative left smile

8. Lips in repose before treatment. Display not appropriate for patient in her twenties.

9. Posterior occlusion waxed up in CR.
Clear silicone matrices of wax-up.
Articulated upper model.

10. Chairside-fabricated composite onlays.
Seating of onlays after air abrasion and
conditioning of surfaces.

11. Full smile after treatment; teeth proportions are correct, and smile esthetics are much improved.

12. Upper arch after treatment; improved alignment
of left cuspid.
Lower arch after treatment.

13. Lips in repose after treatment; display is age-appropriate.

14. Upper anteriors after treatment; tissue profile has been improved, and more healing time is required.

15. Postoperative right smile. Postoperative left smile.

16. Close-up smile after treatment.

17. Full-face smile after treatment.

18. Dr. Hulac is an AACD Accredited Member and part owner of Tam,
Hulac and Partners Ltd., Hong Kong. She is a mentor at the Kois
Center, Seattle, Washington.

19. To receive the quarterly, peer-reviewed Journal of Cosmetic Dentistry,
available to members only, enroll as an AACD member at
www.AACD.com/join