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Prostho 3 > 6. Porcelain laminate veneers > Flashcards

6. Porcelain laminate veneers Flashcards

1
Q

What is a laminate veneer?

A

Extracoronal partial-coverage single-tooth restoration made of porcelain

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2
Q

Characteristic of laminate veneers? (3)

A
  • Highly esthetic
  • highly conservative
  • low geometrical retention
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3
Q

Why are laminate veneers highly esthetic?

A
  • high translucency

- takes advantage of optical properties of the underlying dentin

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4
Q

Why are laminate veneers highly conservative? (4)

A
  • Minimal preparation.
  • Into enamel whenever possible.
  • 0.3 – 0.5 mm thick.
  • Excellent bond to enamel.
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5
Q

Laminate veneers: low geometrical retention?

A
  • very low friction

- adhesive bond

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6
Q

When should we choose a laminate veneer?

A

When you need a maximal long-term esthetic results

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7
Q

What is needed to have laminate veneers? (2)

A
  • healthy tooth structure

- minor color, shape or position alterations

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8
Q

What teeth will we use laminate veneers on?

A

Anterior teeth and premolars

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9
Q

What are the different materials you can use for laminate veneers? (3)

A
  • Feldspatic porcelain
  • e.max + veneering
  • Monolithic e.max
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10
Q

When do you use feldspathic porcelin for laminate veneers? (4)

A
  • max 2 shades of color alteration
  • slight differences with color of the substrate
  • no more than 2mm of lengthening of incisal border
  • low mechanical load
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11
Q

When do you use E.max+veneering for laminate veneers? (4)

A
  • 3 color shades modification or more
  • non-homogenous color of the substrate
  • more than 2mm lengthening of the incisal border
  • bruxism, overbite, high mechanical load
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12
Q

When do you use monolithic e.max for laminate veneers?

A

When the mechanical needs are higher than esthetic ones

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13
Q

Indications of laminate veneers? (4)

A
  • Color alterations
  • shape and size alterations
  • Position alterations
  • to restore anterior guidance
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14
Q

What color alterations are an indication for laminate veneers? (4)

A
  • Tetracycline stains.
  • Dental fluorosis.
  • Hypoplasia stains.
  • Tooth resistant to bleaching.
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15
Q

What shape/size alterations are an indication for laminate veneers? (5)

A
  • Microdontia / conoid teeth.
  • Primary teeth.
  • Tooth fractures.
  • Broad cervical embrasures.
  • Dental erosion
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16
Q

What position alterations are an indication for laminate veneers? (3)

A
  • Diastemata
  • Mild crowding
  • Minor malpositions (e.g: rotations)
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17
Q

What are the tooth classifications for laminate veneers?

A
  • Type I, II, III
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18
Q

What is a type I tooth for laminate veneers?

A

Whitening resistant teeth

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19
Q

What are the different types of type I tooth for laminate veneers?

A

A: grade II and IV discoloration from tetracycline
B: lack of response to external or internal bleaching

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20
Q

What are the different types of type II tooth for laminate veneers? (3)

A

A: conoid shape
B: Closing diasthemas and interdental triangles
C: Increasing length and incisal prominence

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21
Q

What is a type II tooth for laminate veneers?

A

Important morphological changes

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22
Q

What is a type III tooth for laminate veneers?

A

Extensive restorations (adults)

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23
Q

What are the different types of type III tooth for laminate veneers? (3)

A

A: Extensive coronal fractures
B: Extensive loss of enamel due to erosion and wear
C: Acquired and generalized malformations

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24
Q

What are the contraindications of laminate veneers? (6)

A
  • Inadequate occlusion or position
  • multiple restorations
  • inadequate anatomy
  • caries/bad hygiene
  • untreated periodontal disease
  • angle’s class II
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25
Q

Laminate veneer contraindication: what is included in inadequate occlusion or position ? (3)

A
  • deep overbite
  • parafunctional habits (bruxism)
  • severe crowding
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26
Q

Laminate veneer contraindication: what is included in inadequate anatomy? (4)

A
  • short clinical crown
  • thin incisal portion of tooth
  • highly triangular crowns
  • little quantity of enamel
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27
Q

What is type I preparation for laminate veneers?

A

Only buccal

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28
Q

What is type II preparation for laminate veneers?

A

Buccal and incisal preparation

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29
Q

What is type III preparation for laminate veneers?

A

Buccal, incisal and lingual/palatal preparation

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30
Q

Characteristics of type I preparation? (4)

A
  • The most conservative.
  • Requires thick incisal edge.
  • Allows less shape change.
  • Less toughness -> more fractures.
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31
Q

Characteristics of type II preparation? (4)

A
  • Thicker at the incisal edge.
  • Tougher.
  • Allow greater shape changes.
  • same toughness as type III.
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32
Q

Characteristics of type III preparation? (4)

A
  • Increases support of incisal porcelain.
  • Tougher under horizontal forces.
  • Increased retention and stability.
  • Increases adhesion surface.
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33
Q

Which preparation type for laminate veneers considered more adequate?

A

II

34
Q

Which preparation type for laminate veneers is advised against?

A

III

35
Q

What material is used for palatal veneers?

A

LDS

36
Q

Thickness of palatal LDS laminate veneers?

A

0.8-1mm thickness

37
Q

Con’s of palatal LDS laminate veneers?

A

erosion or attrition

38
Q

When do you use palatal LDS laminate veneers? (2)

A
  • When avoiding placing a full coverage crown

- Re-establish occlusal schemes

39
Q

General characteristics of preparation of laminate veneers? (3)

A

• Over enamel whenever possible, especially at the margin—
Better adhesion and less marginal leakage.
• Always conditioned by the diagnostic wax-up.

40
Q

What is the reduction for a laminate veneer? (2)

A
  • 2/3 incisally: 0.5m

- 1/3 gingivally: 0.8mm

41
Q

What is the guiding grooves size for laminate veneers?

A

Special bur with 1.6-2mm depth

42
Q

How do you prepare laminate veneers buccally?

A
  • 856 bur
  • deep chamfer, chamfer or rounded shoulder
  • finish line 0.3mm deep
43
Q

What should the height of the finish line be for buccal laminate veneer prep?

A
  • yuxtagingival

- slightly gingival

44
Q

Proximal preparation of laminate veneers ?

A

FL should end far from visible areas

45
Q

Incisal preparation of laminate veneers?

A

1.5-2mm

high stress area

46
Q

In which tooth will a type III prep for laminate veneers sometimes be needed?

A

lower incisors

47
Q

Lingual prep of laminate veneers? (4)

A
  • Round tapered bur
  • Thickness of 0.5mm
  • Located in the Incisal third
  • Continuity with the interproximal preparation.
48
Q

How is the finish of the prep for laminate veneers? (2)

A
  • Remove edges/angles.

* Open contact points with polishing strips

49
Q

What is the required volume for E max LDS monolithic pressed laminate veneers?

A

0.3mm

50
Q

What is the required volume for E max LDS monolithic milled laminate veneers?

A

0.4mm

51
Q

What is the required volume for E max LDS veneered over press / CAD laminate veneers?

A

0.7mm

52
Q

What is important to remember about the thickness of Emax LDS laminate veneers?

A

Thickness of the veneered ceramic cannot exceed the

thickness of the core

53
Q

What situations do you vary from the standard preparation of laminate veneers? (4)

A
  • Dark tooth color
  • Malpositioned teeth
  • premolars
  • diastema
54
Q

How do you prepare a laminate veneer for a dark tooth color? (2)

A
  • 0.4-0.5mm gingival 1/3

- 0.6-0.7 mm preparation incisal 2/3

55
Q

What is the purpose of the wax up for laminate veneers? (3)

A
  • Mock up
  • Silicone guides
  • Direct provisional
56
Q

What does a silicone guide do for laminate veneers?

A

Helps measure and visualize the amount of tooth structure we need to remove

57
Q

Uses of silicone guides in laminate veneers? (3)

A
  • mock up
  • preparation guide
  • prep of temp veneers
58
Q

How are the margins cut for preparation silicone guides in laminate veneers?

A

With a blade to create the key that will be used for the temporary veneers to
help the material flow or for the mock-up

59
Q

What is the first generation way of guiding the tooth preparation?

A

Fissure guiding burs

60
Q

What is the second generation way of guiding the tooth preparation?

A

Silicon key guide

61
Q

What is the third generation way of guiding the tooth preparation?

A

Aesthetic Pre-evaluative
Temporary (APT)
Technique

62
Q

What is the fourth generation way of guiding the tooth preparation?

A

First Fit
Digital guides for
the preparation
and cementation

63
Q

Do we need a retraction cord for laminate veneer impressions?

A

Yes, double retraction cord

64
Q

How do we use the double retraction cord? (2)

A
  • second cord removed right before taking the impression

- first chord stays in gingival sulcus

65
Q

Why do we use a double retraction cord?

A

Create a better access and

reproduction of the FL

66
Q

How do you do the single step impression for laminate veneers?

A

Taken with PVS: light body : putty silicone in one step

67
Q

What is PVS?

A

an addition silicone

68
Q

How do you take the two step impression for laminate veneers?

A
  1. putty silicone impression

2. light body silicon impression over the previous impression

69
Q

Why are provisionals for laminate veneers complicated? (2)

A
  • low retention of provisional

- low adjustment

70
Q

Why are provisionals not always necessary in laminate veneers?

A
  • preparations are over enamel

- asethetics are unaffected

71
Q

What are the types of provisionals for laminate veneers? (3)

A
  • Resin composite direct provisional.
  • Acrylic resin direct provisional.
  • Acrylic resin indirect provisional.
72
Q

Lab procedure of laminate veneers: cast? (2)

A
  • Master cast is duplicated with investment material.

* Individualization of dies.

73
Q

Lab procedure of laminate veneers: porcelain layering?

A
  • from inside to outside
  • different opacities to cover underlying color
  • 2-3 firings and glazings
74
Q

Lab procedure of laminate veneers: IPS e.max veneers ?

A
  • Lost-wax or CAD/CAM.
  • Lithium disilicate copings.
  • Allows acid etching.
  • Feldspathic veneering porcelain.
75
Q

Laminate veneers: verification? (5)

A
  • Individual fit.
  • Collective fit (contact points).
  • Color verification (modification if needed).
  • Use Try-in pastes or Glycerine.
  • General appearance.
76
Q

What are the types of materials you can use for laminate veneers? (3)

A
  • Feldspathic
  • High leucite
  • Lithium disilicate
77
Q

What does the final shade of laminate veneers depend on?

A

Cement

78
Q

List the surfaces from tooth to veneer in laminate veneers (6)

A
  • etched enamel surface
  • dentin-enamel adhesive
  • composite luting agent
  • dentin-enamel adhesive
  • silane coupling agent
  • etched porcelain veneer
79
Q

Laminate veneer post operative instructions: 24-72 hours (4)

A
  • avoid alcohol
  • avoid hard food
  • avoid foods that can stain
  • careful mastication
80
Q

When should check ups be for laminate veneers?

A

Every 6 months

81
Q

Maintenance for laminate veneers? (4)

A
  • Avoid flour-rich substances.
  • Avoid parafunctional habits.
  • Mouthguard for sporty people.
  • Night mouthguard
82
Q

What is considered a failure of a laminate veneer? (4)

A
  • Fractures.
  • Marginal leakage.
  • Loss of cementation.
  • Gingivitis.

Prostho 3 (11 decks)

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