Dental veneers are custom shells made of tooth-colored materials that are bonded to the front of teeth to improve their color, shape, size or alignment, and can be made of either composite or porcelain; they are used to treat issues like discoloration, crooked teeth, gaps or cracks and improve the aesthetics and function of the smile. The document discusses the different types of veneers, their applications, benefits and risks, as well as the procedures for applying both composite and porcelain veneers.

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.

4.  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

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.

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

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

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.

22. After placing composite veneers

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.

24. Etching Bonding
Finished composite veneers

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.

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.

32. After placing porcelain veneer

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