Dental Veneers
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Dental Veneers

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Dental Veneers Dental Veneers Presentation Transcript

  •  Dental veneers are custom made shells made from tooth colored materials that facilitate covering the front surface of the tooth and these are alternately known as dental laminates. Dental veneers are normally classified under cosmetic dentistry
  •  A composite veneer  can be build up in the mouth by directly placing it  can be fabricated in a dental laboratory A porcelain veneer  made out of cannot be built in mouth and hence fabricated outside and fitted later.
  •  Esthetically compromised anterior teeth Poorly shaped or crooked teeth Stained teeth (intrinsic/extrinsic) Closure of diastemas Enamel hypoplasia Fractured teeth Anatomically malformed teeth Tooth wear
  •  Crowded or misaligned teeth Teeth with inadequate enamel present Patient with habitual clenching and grinding Non-ideal occlusion Periodontal disease Teeth weakened by existing large restorations
  •  Esthetic stability Stain resistant Stronger and durable Gum tissue tolerates porcelain well The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter. Veneers offer a conservative approach to changing a tooths color and shape.
  •  The process is irreversible More costly than composite veneers Not suitable for patients with clenching or grinding habits Not repairable should they chip or crack Tooth may become more sensitive to hot and cold foods and beverages They can dislodge and fall off Technique sensitive
  •  One visit procedure Less expensive Repair potential Chair-side control of the anatomy Minimal irreversible loss of tooth structure
  •  Tend to discolor Wear out quickly Marginal staining Shade matching difficulty Often require repair and replacement
  •  Lips should be symmetrical A pleasing smile should ideally show canine to canine or premolar to premolar
  •  Symmetrical gingiva 75 to 80% of max incisors showing, women show more of their maxillary incisors whereas men typically show more mandibular teeth
  •  Excessive root surface exposure Loss of papilla between teeth Excessive gingival display Uneven gingival contour  How to deal with these problems: For root surface exposure/loss of papillae  Crown lengthening and root grafting For excessive gingival display  Excision of excessive gingiva For uneven gingival contours  Excision of excess gingiva when needed
  •  Understanding tooth light interaction rather than selecting a shade Hue, Chroma, Value Age consideration Natural color progression of dentition  Maxillary central incisor- dominates smile, color, shape and position  Lateral- similar hue to central  Canine- appear darker due to intense Chroma  Premolars- similar to lateral Different shade system Increased translucency  At interproximal surface  At incisal edge Different areas of teeth  Cervical area  Incisal
  •  Comprehensive clinical examination may reveal failing restorations, recurrent decay, marginal leakage, and staining. A full series of intra- and extraoral images are taken for treatment planning, marketing, and case documentation. These images are studied—along with clinical examination notes—prior to treatment so that a basic plan could be formulated. Patient’s preferences must be kept in mind while deciding a treatment plan including his/her financial status.
  •  Anesthetization and tooth isolation Shades of composite are tried on Assessment on a central incisor Any existing composite resin or decay is removed Tooth is roughened and a slight finish line is created Contoured anatomical matrix is placed and wedged loosely Tooth is then etched and a dentin bonding agent is applied Composite is placed and cured and shaped with a composite roller
  •  Basic shape is formed with a finishing diamond bur Embrasures are shaped and refined with three levels of finishing disks Interproximal areas are shaped with abrasive strips Additional polishing and shaping are completed three days later
  • • Bio data: A 25 year old female presented with an unaesthetic smile.• Chief complaint: “Discoloration of my front teeth since childhood”.• Treatment plan: As clinical examination revealed fluorosis of the entire dentition so composite veneers were suggested and carried out on only the anteriors as per the patients demand.
  • After placing composite veneers
  • • Bio data: 35 year old male.• Chief complaint: “Unhappy with the space, shape and color of my front teeth”.• Treatment plan: Suggested porcelain veneer as the optimal treatment but based on cost decided to use composite veneer.
  • Etching Bonding Finished composite veneers
  • First Appointment (VENEER PREPARATIONPROCEDURE) Shade Selection-  Clean teeth with pumice and water  Select a tentative shade with your patient participating Tooth preparation-  A uniform 0.5mm intraenamel reduction is sufficient  Preparations are extended to the gingival crest and into the interproximals without breaking contact  Three ways to manage incisal edge coverage  No incisal edge coverage  Cover incisal edge  Wrap around incisal edge
  •  Impression-  The retraction cord should be left in place if possible during the impression  Use a polysiloxane or polyether material for the impression Temporary Veneers-  They are placed when necessary or desired  Hand sculptured using composite, kept supragingival and attached by spot etching
  • Second Appointment (VENEER CEMENTATIONPROCEDURE) Remove temporary-  Care must be taken not to damage margin areas of preparations Clinical try-in-  Contacts need to be carefully assessed  Proximal contacts can be adjusted
  • CEMENTATION Steps  Try-in paste allow you to mask any underlying color abnormalities and select cement shade.  Apply saline solution to the internal aspect of the veneer.  Etch, rinse, dry but do not dessicate.  Apply primer/adhesive to the tooth and lightly air dry.  Apply cement to the internal aspect of the veneer, seat the veneer, clean off excess cement, light cure.  Floss contacts and adjust occlusion.
  • Biodata: 66 year old female.Chief complaint: “I hate thespots on my front teeth”.Previous medical history:German measles during toothdevelopment resulted inhypoplastic enamel.Previous dental history: Areas ofpitting restored multiple timeswith composite.Treatment plan: Full porcelaincrowns on 11, 21 and 23.
  • After placing porcelain veneer
  •  This procedure is becoming more common in dental offices because everyone wants a great smile It is a great way to change a smile that shows yellowed, stained teeth into one that makes you look fantastic. But remember veneers are not for everyone, and if your teeth are not strong enough you will not be recommended to have the dental veneers applied