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Porcelain laminate veneers /dentist lab technician
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Porcelain laminate veneers /dentist lab technician

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Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.

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Porcelain laminate veneers /dentist lab technician Porcelain laminate veneers /dentist lab technician Presentation Transcript

  • www.indiandentalacademy.com
  • Porcelain Laminates INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • Table of contents  Tooth preparation.  Impression making.  Shade selection.  Provisional restoration. www.indiandentalacademy.com
  •  Lab communication.  Lab Fabrication.  Try- in considerations.  Luting of porcelain laminate veneers.  Finishing and polishing  Failures  Lumineers  Conclusion  References. www.indiandentalacademy.com
  • Tooth preparation 9. Incisal preparation If reduce, then how much?? A) window . B) feather. C) bevel . D) incisal overlap. www.indiandentalacademy.com
  • Old concept  1980s- the common trend was to preserve the incisal edge in the interests of tissue conservation.  higher number of fractures observed. Why????  Where the free edge is not overlaid, the occlusal third of the laminate veneer is often very thin (less than 0.3 mm).  When the teeth are very slender, the difference in resilience between the prepared natural tooth and the laminate veneer can, under certain occlusal constraints, lead to cracking or fracturing of the ceramic. www.indiandentalacademy.com
  • Recent concept  complete coverage of the incisal edge. advantages  It restricts angle fractures.  It enhances the esthetic properties of laminate veneers.  It enables occlusion to be adjusted.  It facilitates handling and positioning of the laminate veneer at try-in and, in particular, during bonding.  It enables the margin to be placed outside the area of occlusal impact. www.indiandentalacademy.com
  • Tooth preparation  The labial cusp(maxillary or mandibular)should be reduced by at least 1 mm.  The occlusal margin should be placed away from the occlusal contact and grooves The overlay extends to the occlusal three-quarters of the labial cusp, the margin being produced with a spherical bur and connected with the proximal margins by a rounded angle. Premolar : www.indiandentalacademy.com
  • Impression making  Materials  Rubber base impression materials such as addition silicones or polyether. www.indiandentalacademy.com
  •  Trays:  Custom made or stock full arch impression trays are used. www.indiandentalacademy.com
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  • Embrasure blockout www.indiandentalacademy.com
  • Inteproximal tear through margin. www.indiandentalacademy.com
  • Embrasure blockout. www.indiandentalacademy.com
  • Intact interproximal extension. www.indiandentalacademy.com
  • Provisional restorations  Usually not necessary.  In several clinical situations, provisionalization may be required. www.indiandentalacademy.com
  •  If excessive reduction is done to align the tooth.  To prevent supraeruption of the prepared tooth.  If isolated teeth are prepared.  High esthetic expectations. www.indiandentalacademy.com
  •  Materials that can be used for provisional restorations: Acrylics.(SNAP (PARKEL), TEMPLUS (ELLMAN) ,JET (LANG) , DURCALAY (RELIANCE) Composites.( Revotec, Protemp Grant, Unifast L C) www.indiandentalacademy.com
  •  Techniques : Direct technique.( acrylic, composites) Indirect technique. (acrylic, composites) www.indiandentalacademy.com
  •  Direct technique ( acrylic resin). JPD 1989;2;4;139 www.indiandentalacademy.com
  •  FACIAL IMPRESSION OF PROPOSED SITE IS MADE ON A TONGUE BLADE USIND IRREVRSIBLE HYDROCOLLOID IMPRESSION MATERIAL.  IMPRESSION CAN BE OBTAINED FROM PATIENT OR FROM AN ESTHETICALLY ALTERED DIAGNOSTIC CAST www.indiandentalacademy.com
  •  PREPARE THE TOOTH FOR LAMINATE RESTORATION,  USING NO. 2 ROUND BUR MAKE RETENTIVE DIMPLES ON MESIAL AND DISTAL AXIAL WALLS, 1mm ABOVE THE CONTACT AREA. www.indiandentalacademy.com
  •  WET THE TREATMENT SURFACE WITH EXACTLY ONE DROP OF ACRYLIC RESIN MONOMER.  USING SPEEDI TEMP POLYMER RESIN BLOWER APPLY ACRYLIC RESIN POLYMER.  REPOSITION THE IMPRESSION NTRAORALLY. www.indiandentalacademy.com
  •  RESIN WILL SUFFICIENTLY PENETRATE THE DIMPLES  AS ACRYLIC RESIN IS APPLIED SPARINGLY ONLY SMALL EXCESS WILL BE EXPRESSED OUTSIDE  PROVISIONALS ARE FINISHED AND POLSIHED www.indiandentalacademy.com
  • DIRECT TECHNIQUE  ( J. ESTHET RESTOR DENT 2001,13;115- 119) www.indiandentalacademy.com
  • STOCK TRAY IMPRESSION MADE PRIOR TO TOOTH PREPRATION USING BITE REGISTRATION MATERIAL ( REGISIL RIGID, DENTSPLY ) www.indiandentalacademy.com
  •  VENEER PREPRATION ACCOMPLISHED WITH SLIGHT SUPRAGINGIVAL MARGINS  SELF ETCHING DENTIN – ENAMEL ADHESIVE SYSTEM (PROMPT L-POP ESPE AMERICA INC.) WAS APPLIED www.indiandentalacademy.com
  • TEMPHASE (KERR CORP. ) – TWO COMPONENT ( CATALYST AND BASE ) BIS- METHYACRYL HYBRID TEMPORARY CROWN AND BRIDGE MATERIAL LOADED IMRESSION IS SEATED OVER THE PREPARED TEETH HELD IN PLACE TILL THOROUGHLY CURED . www.indiandentalacademy.com
  •  IMPRESSION IS REMOVED AND THE RESIN REMAINING ON THE TEETH IS EXPOSED TO VISIBLE WAVELEGNTH CURING LIGHT  USING CARBIDE FINISHING BURS, FLASH IS REMOVED  OCCLUSION IS CHECKED AND ADJUSTED , PROVISIONALS ARE POLISHED USING CONVENTIONAL COMPOSITE POLISHING KIT www.indiandentalacademy.com
  •  Indirect method:(composites) www.indiandentalacademy.com
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  • BONDING OF PROVISIONAL RESTORATION  Composites.  Provisional Non- eugenol cements. www.indiandentalacademy.com
  • THINGS NEEDED FOR GOOD COMMUNICATION ARE.  Laboratory prescription.  Pretreatment models.  Photographs of the teeth.  Accurate impressions. www.indiandentalacademy.com
  • Lab prescription.  A complete lab prescription consists of the following:  1. shade of the prepared teeth.  2. shade of the veneer: cervical, body, incisal.  3. appropriate interface space in die spacer coats.  4. veneer length, contacts, incisal shape. www.indiandentalacademy.com
  • Shade selection  Because ceramic veneers are thin, color from the underlying tooth may alter the final veneer shade.  Without prescribing the background of the tooth to be veneered it is difficult to select the shade of the veneer. www.indiandentalacademy.com
  •  Shade of the prepared tooth: www.indiandentalacademy.com
  •  Shade gradation of the veneer: www.indiandentalacademy.com
  •  Die spacer: 0.1 mm die spacer for two- shade shift. 0.2mm for profoundly stained teeth. www.indiandentalacademy.com
  •  Translucency and opacity levels:  Use of highly opaque porcelain gives non-vital look.  Trend is to use translucent and highly characterized porcelain combined with increased die spacing. www.indiandentalacademy.com
  • Length, contacts and incisal shape:  Veneer length relative to the prepared tooth.  Contact zone (long or short)  Tooth shape( tapered, square)  Incisal shape (round, square, variable). www.indiandentalacademy.com
  • Communication with desired contour and tooth shape. www.indiandentalacademy.com
  • Lab fabrication  Platinum foil technique.  Refractory die technique.  Direct casting  CAD-CAM technique www.indiandentalacademy.com
  • Platinum foil technique www.indiandentalacademy.com
  •  Stone working model seperating dies www.indiandentalacademy.com
  • Die spacer www.indiandentalacademy.com
  • Platinum foil adapted on the die www.indiandentalacademy.com
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  • APPLY GINGIVAL CERAMICS www.indiandentalacademy.com
  • Apply dentine porcelain. www.indiandentalacademy.com
  • Cutting back mesial and distal surfaces for enamel porcelain www.indiandentalacademy.com
  • Application of enamel porcelain. www.indiandentalacademy.com
  • Yellow stains on the incisal edges www.indiandentalacademy.com
  • Completed veneer www.indiandentalacademy.com
  • The veneers should be colored and glazed prior to foil removal. www.indiandentalacademy.com
  • Refractory die technique.  Advantages: 1. Overall accuracy and fit is generally better. 2. Easier technique. www.indiandentalacademy.com
  •  Disadvantages: 1.Requires duplication of stone dies. 2.Divestment is required. 3.Fit must be verified on stone dies. 4.More difficult to control veneer thickness. www.indiandentalacademy.com
  •  Refractory cast trimmed with stone base. www.indiandentalacademy.com
  • Dies are placed in the ceramic oven. www.indiandentalacademy.com
  • Cooled to room temperature and soaked in distilled water. www.indiandentalacademy.com
  • Application of the opaque layer. www.indiandentalacademy.com
  • Full contour ceramic buildup. www.indiandentalacademy.com
  • Contouring the veneers on the dies. www.indiandentalacademy.com
  • Disc used to cut the veneer away from the die. www.indiandentalacademy.com
  • Excess is removed from the stone. www.indiandentalacademy.com
  • Air abraded. www.indiandentalacademy.com
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  • Porcelain etching  Hydrofluoric acid is applied to the fitting surface of the veneer.  Provides good bonding strength by partly dissolving the glassy matrix of the porcelain. www.indiandentalacademy.com
  • Apply wax to the areas not etched www.indiandentalacademy.com
  • Internal bonding surface etched with hydrofluoric acid. www.indiandentalacademy.com
  • Properly etched- foggy appearance www.indiandentalacademy.com
  • Under etched- shiny appearance www.indiandentalacademy.com
  •  Swift B et al., (BDJ 1995; 179: 203-20)  Do not place the etched veneers back on the master cast because it will contaminate their fitting surfaces and adversely affect bonding strength. www.indiandentalacademy.com
  • Veneer try-in www.indiandentalacademy.com
  • Chair side try- in.  Three steps: 1.Dry try-in of individual veneer for marginal fit. 2.Wet try-in of all veneers collectively with a clear liquid medium, for proximal fit. 3.Resin cement try-in. www.indiandentalacademy.com
  • Dry try-in for marginal fit.  Place the gingival retraction cord subgingivally to prevent sulcular moisture or bleeding from contaminating the surface.  Try each veneer individually in dry to determine marginal accuracy. www.indiandentalacademy.com
  • Each veneer is placed dry on the prepared tooth to check marginal fit. www.indiandentalacademy.com
  • Wet try-in for proximal fit.  Fill the internal etched surface with water soluble glycerin to minimize dislodgement if a vertical position is assumed.  Try veneers on appropriate teeth in sequential manner.  If the veneer resists seating remove the veneer and carefully reduce using microfine diamond bur. www.indiandentalacademy.com
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  • All veneers are seated to check the marginal fit. www.indiandentalacademy.com
  • Veneer try-in for color and color modifications. www.indiandentalacademy.com
  •  If the try-in is lighter than a intended shade.  Use resin cement that is darker or approximately same degree. www.indiandentalacademy.com
  •  If it is darker than the intended shade  Mix one part of light opaque resin cement with ten parts of light translucent resin cement. www.indiandentalacademy.com
  • If generalised polychromatic shade modification needed only for a portion of veneer . www.indiandentalacademy.com
  •  High chroma composite tint on inner gingival surface. www.indiandentalacademy.com
  •  Grey tint on the inner incisal third. www.indiandentalacademy.com
  • TRADE NAMES OF RESIN CEMENTS.  NEXUS (KERR)  PVS PORCELAIN BONDING  KIT(JELENKO)  INSURE (COSMODENT)  COMPOLUTE (ESPE)  VIRIOLINK (VIVADENT) www.indiandentalacademy.com
  •  VENEER LUTING AGENT (BISCO)  RECOVER(TELEDYNE GETZ )  MIRAGE FLC(CHAMELEON)  RELY X VENEER CEMENT(3 M ESPE) www.indiandentalacademy.com
  • Cementation and finishing  Good moisture control is necessary. www.indiandentalacademy.com
  • Gingival retraction  Gingival cords: •Retraction cord is of great help to prevent contamination from gingival crevice www.indiandentalacademy.com
  •  Gingval cords come in different sizes:  Ultrapak plain and ultrapak E (epinephrine impregnated)  Knitted.  # 00,#0,#1,#2. www.indiandentalacademy.com
  • Veneer preparation.  Ultrasonically clean the veneer in acetone for 5 mins www.indiandentalacademy.com
  • Dry thoroughly and apply silane coupling agent www.indiandentalacademy.com
  • Tooth preparation. www.indiandentalacademy.com
  • CLEAN TOOTH WITH PUMICE www.indiandentalacademy.com
  • Check interproximal contacts of the teeth using metal strips(0.0005’’) www.indiandentalacademy.com
  • PASSING OF ULTRA THIN DIAMOND COATED METAL STRIP TO LIGHTEN THE CONACTS www.indiandentalacademy.com
  • METAL STRIP PLACED www.indiandentalacademy.com
  • LOADING VENEER WITH RESIN CEMENT www.indiandentalacademy.com
  • SEATING THE VENEER www.indiandentalacademy.com
  • VENEER CARRYING STICKS (GRAB IT-CHAMELEON DENTAL PRODUCTS) www.indiandentalacademy.com
  • EXCESS CEMENT www.indiandentalacademy.com
  • REMOVING EXCESS RESIN www.indiandentalacademy.com
  • REMOVING EXCESS CEMENT FROM LINGUAL MARGIN www.indiandentalacademy.com
  • VENEER TACKED BY LIGHT CURING A SMALL SEGMENT www.indiandentalacademy.com
  • REMOVE ANY EXCESS LEFT www.indiandentalacademy.com
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  • CURED RESIN CEMENT EXCESS REMOVE LONG POINTED 30 FLUTED CARBIDE BUR SCALER OR CURETTE www.indiandentalacademy.com
  • FINISHING STRIPS- REMOVE INTERPROXIMAL EXCESS www.indiandentalacademy.com
  • ADJUST OCCLUSAL CONTACTS www.indiandentalacademy.com
  • POLISH USING CERAMIC POLISHING RUBBER CUPS www.indiandentalacademy.com
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  • Failures www.indiandentalacademy.com
  • Failures  between resin and veneer is likely due to poor etch of veneer or old silane  between tooth and resin the problem is bonding materials, placement technique, bonding substrate www.indiandentalacademy.com
  •  To re-bond a veneer all resin must be removed from the veneer. This is done in the lab by heating to 600* C and re-etching, washing, drying, and re-silanating the veneer Failures  Etch with 9.5% hydrofluoric acid for 4 mins. or 1.23% acidulated phosphate fluoride, or air abrasion with 50mu aluminum oxide  wash, dry, silanate  then use conventional bond/C.R. system www.indiandentalacademy.com
  • Newer clinical applications www.indiandentalacademy.com
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  • Differences between lumineer and traditional laminates Laminates 1. More tooth preparation 2. Not reversible 3. Anesthesia needed. 4. gingival cord placement 5. Temporaries needed. 6. 0.5 to 0.75mm thickness Lumineers 1. No or minimal preparation 2. Reversible 3. No anesthesia 4. No gingival cord 5. No temporaries 6. 0.2mm thickness www.indiandentalacademy.com
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  • refereneces 1PORCELAIN LAMINATE VENEERS:GRABER,GOLDSTEIN,FEIN MAN 2.THE SCIENCE AND ART OF DENTAL CERAMICS:JOHN W. McLEAN(VOL.I AND II) 3.PORCELAIN LAMINATE VENEERS FOR DENTISTS AND TECHNICIANS:ROGER J. SMALESwww.indiandentalacademy.com
  • 4.FUNDAMENTALS OF ESTHETICS:CLAUDE R. RUFENACHT 5.CONTEMPORARY ESTHETIC DENTISTRY:BRUCE J. CRISPIN 6.PORCELAIN LAMINATE VENEERS:A PRELIMINARY REVIEW(BDJ 1988:9:9-14) www.indiandentalacademy.com
  • 6.A PROVISIONAL RESTORATION TECHNIQUE FOR LAMINATE VENEER PREPARATIONS:(JPD 1989:62:139-142) 7.ADVANTAGES AND LIMITATIONS OF PLV:(JPD:1990:64:406-411) 8.PREDICTABILITY OF COLOUR MATCHING :(JPD 1991:65:619-22 www.indiandentalacademy.com
  • 9.THE SCIENCE AND ART OF DENTAL CERAMICS:J.W.MCLEAN: (J.OPERATIVE DENTISTRY:1991:16:149-156) 10.REMOVAL OF PARTIAL OR FULLY POLYMERISED RESIN FROM PORCELAIN VENEERSJPD 1993:69:443-444) www.indiandentalacademy.com
  • 11.COMPARISON OF FIT OF PORCELAIN VENEERS FABRICATED USING DIFFERENT TECHNIQUES:IJP 1993:6:36-42 12.CASE SELECTION FOR PLV:QUINT INT;1995;26;311-315 www.indiandentalacademy.com
  • 13.A REVIEW OF ALL CERAMIC RESTORATIONS:JADA 1997:128:297-307 14.FIVE YEAR CLINICAL PERFORMANCE OF PORCELAIN VENEERS:QUINT INT :1998:29:211-221) 15.VITAPAN 3D-MASTER:THEORY AND PRACTICE:QDT:1999;43-53 www.indiandentalacademy.com
  • Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com