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VENEERSSUBMITTED BY

NESHEENA .V .K

PART 1

PSM DC

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CONTENT

• Veneers• Definition

• Indication

• Contraindication

• Type

• Direct veneer technique

• Indirect veneer technique• Directly applied composite veneer

• Processed composite veneer

• Lumineer

• conclusion

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Definition• A veneer is a layer of tooth-colored material that is applied to a tooth to

restore localized or generalized defect and intrinsic discolorations.

(Sturdevant's art & science operative dentistry)

typically, veneers are made of directly applied composite, processed composite , porcelain, or pressed ceramic materials.

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Indications• Improve extreme discolorations such as tetracycline staining,

flourosis, devitalized teeth, and teeth darkened from age.

• Repair chipped or fractured teeth.

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• Closing of diastemas between teeth.

• Ability to lengthen anterior teeth.

• Improve the appearance of rotated or misaligned teeth

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Contraindication• If little or no enamel is present, full crown should be considered.

• Certain tooth-to-tooth habits like bruxing or clenching, or other para-functional habits such as pencil chewing or ice crushing.

• Teeth that exhibit severe crowding.

• Certain types of occlusal problems such as Class III & end-to-end bites

• Poor oral hygiene.• High caries rate.

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TypesBased on extent of tooth involved;- 1.Partial veneers 2.Full veneers

• Partial veneers are indicated for the restoration of localized defects or areas of intrinsic discoloration.

• Full veneers are indicated for the restoration of generalized defects or areas of intrinsic staining involving most of the facial surface of the tooth.

Window preparation

Butt-joint incisal preparation Incisal lapping preparation

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• Two basic preparation designs exists for full veneers:1. Window preparation:2. Incisal, lapping preparation

3. Window preparation:• it is recommended for most direct and indirect composite

veneers.• This intraenamel design preserves the functional lingual and

incisal surfaces of the maxillary anterior teeth, protecting the veneers from significant occlusal stress.

• By using a window preparation,the functional surfaces are better preserved in enamel.

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2.Incisal-lapping preparation

• It is indicated when the tooth being veneered needs lengthening or when an incisal defect warrants restoration.

• This design is used frequently with porcelain veneers because it not only facilitates accurate seating of the veneer on cementation ,but it also allows for improved esthetics along the incisal edge.

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Based on the type of material employed;-• Directly applied composite veneer

• Processed composite veneer

• Porcelain or pressed ceramic veneer

Based on the mode of fabrication;-

Direct veneers• Direct partial• Direct full

Indirect veneers• No-prep veneer• Etched porcelain veneer• Pressed ceramic veneer

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composite veneers

Advantages•One visit procedure•Less expensive•Repair potential•Chair-side control of the anatomy•Minimal irreversible loss of tooth structure.

Disadvantages•Tend to discolor•Wear out quickly •Marginal staining•Shade matching difficulty •Often require repair and replacement

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• Very conservative.• Offer better inherent color and

natural look.• Tissue tolerance is excellent.• Less staining.• The bond of etched porcelain veneer

to enamel is stronger than other.• Wear and abrasion resistance is

high.• The aesthetics are better than any

other veneer material.• Porcelain veneer allow transmission

of light.adva

ntag

e

•Expensive. •Tooth preparation.•Highly sensitive technique. •Sensitivity.• It has number of limitation

Conventional Porcelain Veneers:D

isadvantage

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• When only a few teeth are involved, or when the entire facial surface is not faulty (i.e., partial veneers), directly applied composite veneers can be completed chair side for the patient in one appointment.

• Indirect veneers require two appointments, but typically offer three advantages over directly placed full veneers, as follows:

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1. Indirectly fabricated veneers are much less sensitive to operator technique. Indirect veneers are made by a laboratory technician and are typically more esthetic.

2. If multiple teeth are to be veneered, indirect veneers usually can be placed much more expeditiously.

3. Indirect veneers typically last much longer than direct veneers, especially if they are made of porcelain or pressed ceramic.

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Direct veneer techniques • Are indicated for the restoration of localized defects or

areas of intrinsic discoloration• These defect can be restore in one appointment with light-cured

composite.

• Steps

Direct partial veneers

Direct full veneers

Dire

ct p

artia

l ven

eers

cleaning Shade selection isolation Removal of the defect &

tooth preparation .depth is 0.5 to 0.75 mmetching

Restoration of cavity with composite resin (microfilled)

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• Extensive enamel hypoplasia of anterior teeth

• Diastema

• Tetracycline stained teeth

• One or two appointment

• Steps

Dire

ct f

ull v

enee

rsindications

cleaning

Shade selection

Isolation & gingiva is retracted

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2

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Window Tooth preparation with

coarse round diamond bur .depth is 0.5-0.75

mm mid facially & tapering down to a

depth of 0.2-0.5 mm along gingival margin

After etching,rinsig, & drying procedure. applied

the composite .

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Indirect veneer technique• Indirect veneer are made of

1. Processed composite

2. Feldspathic porcelain

3. Cast or pressed ceramic

• Two appointment are required

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• Composite Veneers• One visit procedure• Less expensive• Repair potential• Chair-side control of the

anatomy• Minimal irreversible loss of

tooth structure

• Porcelain Veneers• 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.

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Processed composite veneersFirst Appointment*Window preparation recommended due to limited bond strength.*Incisal lapping if incisal defect.*Intraenamel preparation.*Elastomeric impressions.*No temporization.

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Second AppointmentEvaluate fit of veneer.Tooth side of veneer (pre etched) is primed.Tooth etched, rinsed and dried. Adhesive is applied but not cured.Adhesive cement applied.Veneer placed and excess cement removed.Light cured for 40-60sec facial & lingual.* Check for fit with no.2 explorer.

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Etched porcelain veneerA Etched porcelain veneer is a thin piece of porcelain that is bonded to the front of a tooth. Porcelain is a durable, translucent, strong, natural-looking, and beautiful material.The only difference in this procedure for porcelain veneers from the composite veneers is the need to condition the internal surface of each veneer with a silane primer just before applying the resin-bonding agent

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FIRST APPOINTMENT (Veneer Preparation

Procedure)

Shade Selection

Tooth preparation

Impression

Temporary Veneers

SECOND APPOINTMENT

Remove temporary

Clinical try-in

Cementation

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• Labial reduction - Interproximal reduction

• Incisal modification - Cervical definition

• Place a horizontal facial depth cut, it is usually 0.3 mm from proximal line angle to proximal line angle. Make this depth cut at the junction of the cervical and middle one-third of the facial surface of the tooth.*

• Paralleling the entire gingival margin, prepare a definitive chamfer finish line.

• Continue the definitive chamfer finish line with diamond bur from the papilla tip toward the incisal edge on both the mesial and distal proximal surfaces.

• The facial depth cuts are removed with the diamond bur, and the long axis of the diamond bur is “rolled” into the proximal chamfer area to eliminate any sharp line angles

Tooth preparation

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Labial reduction Interproximal reduction Incisal modification Cervical definition

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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

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The laboratory procedures

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Second Appointment

Clinical try-inContacts need to be carefully

assessed Proximal contacts can be adjusted

Remove temporaryCare must be taken not to damage margin areas of preparations

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Cementation 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 desiccate

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.

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LumineerDifference between Lumineers and standard porcelain veneers• The main difference is that Lumineers are made from a special

patented cerinate porcelain that is very strong but much thinner than traditional laboratory-fabricated veneers. Their thickness is comparable to contact lenses.

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Advantage• Lumineers can be placed on the teeth without removal of the tooth

structure.

• Patients can receive their veneers quickly, usually within two weeks from the date that the impressions are made.

• Lumineers bond directly to the tooth, making the bond very strong. They are also very long-lasting- up to twenty years or longer.

• Lumineers are a reversible procedure.

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The LUMINEERS Minimal Contouring Technique

• requires slight modification of the enamel but never touches dentin during LUMINEERS placement. Only0 .3 mm-0.5 mm enamel is removed, causing no sensitivity for the patient and therefore no need for any anesthesia.

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Before & After

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Conclusion• This procedure is becoming more common in dental offices

because everyone want a great smile.

• It is a great way to change a smile that shows yellowed, stained teeth into one that make you look fantastic.

• But remember veneers are not for everyone, & if your teeth are not strong enough you will not be recommended to have the dental veneers applied.

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BIBLIOGRAPHY•Sturdevant's art & science operative dentistry•Essential of operative dentistry I Anand Sherwood•Textbook of operative dentistry sumeeta sandhu •Dr. Lazare's The Patient's Guide To Dentistry

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