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Dental Veneers
1.
2. 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
3. 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.
5. 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
6. 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 tooth's color
and shape.
7. 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
8. One visit procedure
Less expensive
Repair potential
Chair-side control of the anatomy
Minimal irreversible loss of tooth structure
9. Tend to discolor
Wear out quickly
Marginal staining
Shade matching difficulty
Often require repair and replacement
10. Lips should be symmetrical
A pleasing smile should ideally show canine to canine or premolar
to premolar
11. Symmetrical gingiva
75 to 80% of max incisors showing, women show more of their
maxillary incisors whereas men typically show more mandibular
teeth
12. 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
13. 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
14. 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.
15.
16. 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
17.
18. 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
19.
20.
21. • 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.
23. • 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.
26. First Appointment (VENEER PREPARATION
PROCEDURE)
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
27. 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
28. Second Appointment (VENEER CEMENTATION
PROCEDURE)
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
29. 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.
30.
31. Biodata: 66 year old female.
Chief complaint: “I hate the
spots on my front teeth”.
Previous medical history:
German measles during tooth
development resulted in
hypoplastic enamel.
Previous dental history: Areas of
pitting restored multiple times
with composite.
Treatment plan: Full porcelain
crowns on 11, 21 and 23.
33. 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