This document discusses and compares prepared and minimal preparation ("prep-less") veneers from the perspectives of two dental professionals, Drs. Brian LeSage and Dennis Wells. It addresses myths versus realities of each approach and provides examples of cases where each method was used. Prep-less veneers are shown to provide esthetic results with minimal risk when bonded exclusively to enamel, while also maintaining healthy gingiva. When volume increase can be tolerated, prep-less veneers offer multiple benefits to patients as a less invasive procedure. Overall, the document highlights that minimal preparation techniques for veneers align with trends in dentistry and medicine toward less invasive treatments.

1. Two Viewpoints:
Prepared and Minimal Prep Veneers
Drs. Brian LeSage & Dennis Wells

2. 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 the
AACD’s Journal of Cosmetic Dentistry, Summer 2011 issue.
For more information, visit. www.AACD.com.

3. LeSage: Preoperative retracted view showing diastemas, slight rotations, and
asymmetries. Orthodontic treatment was declined even after an Invisalign work-up
and ClinCheck.
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dentistry—and the value of Accreditation—to the
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4. Bis-acrylic placed on unprepared
teeth using a putty matrix made
from the diagnostic wax-up as a
preparatory guide. Demonstrates
full and final contour of definitive
minimally invasive porcelain
restorations.
Depth-cutting grooves using a
.5-mm depth-cutting bur directly into
the bis-acrylic. Red and blue pencil
lines are placed in grooves for ease
of visibility.

5. Bis-acrylic preparatory guide Bis-acrylic removed from ##6-11.
removed from ##6-8, showing Note some areas have not even been
minimal reduction to enamel to touched; no preparation was needed
achieve diagnostic workup result. in those zones except to be
contiguous with the remaining
preparation.

6. The myth that prepared veneers need to be .75 to 1 mm in depth, which leads to
exposed dentin, has contributed to over-preparation in many cases.
Occlusal view showing depth-cutting grooves. No area has even .5 mm of prepared enamel.

7. Final preparation to allow for diastema closures and rotations. There is no dentin
exposure with the aid of preplanning and a bis-acrylic preparatory guide.

8. All-porcelain restorations on ##6-11 Retracted image demonstrating
showing desired esthetic outcome. This esthetic and gingival health issues
outcome is expected when bonding that can arise with improper
exclusively to enamel and with minimal diagnostic and esthetic planning with
preparation with gingival health in prep-less veneers.
mind.

9. Wells:
Prep-less
(DURAthin;
Brentwood, TN)
veneers, ##5-12.

10. Prep-less veneers, ##5-12. Note
the pleasing emergence profile
and excellent tissue health.
Feathered “infinity” margins at 1:1.
Note undetectable margins and
excellent tissue health.

11. Zekrya retraction instrument (DMG Liquid dam used to protect tissue
America; 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.

12. 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.

13. 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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