Two Viewpoints:Prepared and Minimal Prep VeneersDrs. Brian LeSage & Dennis Wells
Two dental professionals on the treatment of two modalities. Drs. Brian LeSage and Dennis Wells address some “myths vs. realities” regarding prepared and “prep-less” veneers.Adapted from the full article, which originally appeared in theAACD’s Journal of Cosmetic Dentistry, Summer 2011 issue. For more information, visit. www.AACD.com.
LeSage: Preoperative retracted view showing diastemas, slight rotations, andasymmetries. Orthodontic treatment was declined even after an Invisalign work-upand ClinCheck. • Members expect the AACD to promote cosmetic dentistry—and the value of Accreditation—to the general public - position the Academy as the go-to cosmetic dentistry resource for the media - increase awareness for the benefits of cosmetic dentistry - increase awareness for working with an AACD member - drive consumers to AACD Find-a-Dentist locator
Bis-acrylic placed on unpreparedteeth using a putty matrix madefrom the diagnostic wax-up as apreparatory guide. Demonstratesfull and final contour of definitiveminimally invasive porcelainrestorations.Depth-cutting grooves using a.5-mm depth-cutting bur directly intothe bis-acrylic. Red and blue pencillines are placed in grooves for easeof visibility.
Bis-acrylic preparatory guide Bis-acrylic removed from ##6-11.removed from ##6-8, showing Note some areas have not even beenminimal reduction to enamel to touched; no preparation was neededachieve diagnostic workup result. in those zones except to be contiguous with the remaining preparation.
The myth that prepared veneers need to be .75 to 1 mm in depth, which leads toexposed dentin, has contributed to over-preparation in many cases.Occlusal view showing depth-cutting grooves. No area has even .5 mm of prepared enamel.
Final preparation to allow for diastema closures and rotations. There is no dentinexposure with the aid of preplanning and a bis-acrylic preparatory guide.
All-porcelain restorations on ##6-11 Retracted image demonstratingshowing desired esthetic outcome. This esthetic and gingival health issuesoutcome is expected when bonding that can arise with improperexclusively to enamel and with minimal diagnostic and esthetic planning withpreparation with gingival health in prep-less veneers.mind.
Zekrya retraction instrument (DMG Liquid dam used to protect tissueAmerica; Englewood, NJ) used to during final polishing.protect tissue while finishing. Thin, prep-less porcelain veneers are very strong and durable once bonded to 100% enamel; they have as good as or better long-term results than prepared veneers.
Five-year recall of prep-less veneers, ##5-12, demonstrating excellent durability and stability. Prep-less (DURAthin) veneers,##5-12. Note inherent warmth of color in the gingival one-third.
When an increase in volume is desired or can be tolerated,prep-less veneers are an incredible service to offer to patients, with multiple benefits and minimal risks. Much like medicine, dentistry is steadily moving toward less invasive procedures and this trend is not likely to change.
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