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Porcelain Laminate Veneers

1. Indications for Veneer Placement

   1. 1. Stained or darkened teeth

   2. 2. Hypocalcification

   3. 3. Multiple diastemas

   4. 4. Peg laterals

   5. 5. Chipped teeth

   6. 6. Lingual positioned teeth

   7. 7. Malposed teeth not requiring orthodontics

2. Contraindications for Veneer Placement Include:

   1. 1. Insufficient tooth substrate (enamel for bonding )

   2. 2. Labial version

   3. 3. Excessive interdental spacing

   4. 4. Poor oral hygiene or caries

   5. 5. Parafunctional habits (clenching, bruxism)

   6. 6. Moderate to severe malposition or crowding

3. Advantages of Veneers Include:

   1. • Minimal tooth preparation required

   2. • Porcelain veneers are stronger and more durable than composite veneers

   3. • Alternative to full coverage restoration in case of incisal fractures or tooth discoloration

   4. • Color stability

4. Disadvantages of Veneers Include:

   1. • Potential for over-contouring

   2. • Requires laboratory procedures

   3. • Porcelain enamel margins may be thin and difficult to finish

   4. • Brittle margins

   5. • Pitting by acidulated fluoride treatment

   6. • Cannot be repaired easily

   7. • Can sometimes be difficult to temporize

   8. • Color cannot be altered substantially after placement

   9. • Placement is difficult and time-consuming

5. Clinical Procedure

   1. Treatment Plan Phase

      1. 1. Check for contraindications

      2. 2. Mount study casts

      3. 3. Check posterior occlusion (anterior teeth do not function alone)

      4. 4. Confirm that there is no protrusive or lateral interference

      5. 5. Check centric anterior lingual contacts

      6. 6. Consider three key elements of esthetics: contour, position and color

   2. Clinical Procedure - Visit 1

      1. 1. Impression for study models/bite registration record

      2. 2. Radiographs/photographs

      3. 3. Check contraindications

      4. 4. Shade selection

   3. Clinical Procedure - Visit 2

      1. 1. Confirm shade selection

      2. 2. Preparation

         1. Types of Veneer Preparation

            1. 1. Incisal Chamfer Preparation (Interlock prep) The incisal edge is not reduced in length.

            2. 2. Incisal Butt-Joint Preparation

            3. 3. Incisal Lingual Wrap Preparation

            4. 4. The path of insertion for veneers is in the labial or incisal-labial direction.

      3. 3. Check contraindications

         1. Final Impression

         2. Laboratory Instructions

         3. Temporization

   4. Clinical Procedure - Visit 3

      1. Veneer Cementation

         1. 1. Try-In/Shade Selection

         2. 2. Cementation

         3. 3. Finishing

         4. 4. Night guard

6. Reference : Crest Oral-B at dentalcare.com Continuing Education Course, Revised December 5, 2008