Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IRS > laminate veneers > Flashcards

laminate veneers Flashcards

1
Q

What is a good smile associated with?

A

Good health
Youth
Good social status
Success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can a not very good smile effect?

A

Personality

Sociability and sociality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do you ask a patient if they dont like how their teeth

A 
What they dont like
How long had this problem
Why it has occurred 
Has it improved 
How would they like it altered 
Look and listen to the pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What questions does the dentist need to decide?

A

Alternative treatment? Ortho, crowns, implants, surgery
Pre-treatment? bleaching, crown lengthening, restoration
Which veneer prep?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a veneer?

A

A layer of tooth-coloured material that is applied to the tooth to restore localised or generalised defects and intrinsic discolourations
A thin and translucent fabricated by either ceramic or composite material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can a veneer improve?

A

Shape, colour and position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When did ceramic laminate veneers start being an option?

A

1980’s
After the introduction of acid etching, bis-GMA, ceramic surface treatment and bonding
These all triggered the use of veneers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the indications for veneers?

A 
Colour defects or abnormalities 
Abnormalities of shape
Abnormal structure or texture 
Malpositioning 
Diastema
Missing teeth 
Lingual laminate veneers
Lengthening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What could cause discolouration/abnormalities in the tooth?

A

Amelogenesis imperfecta, medication, fluorosis, age, trauma, extrinsic staining with infiltration of tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the different abnormalities in shape of teeth?

A

Microdontia
Atypical tooth shape
Malformed incisor
retained deciduous teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can cause abnormal structure or texture of teeth?

A 
Dysplasia,
Erosion
Attrition
Abrasion
Coronal fracture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do lingual laminate veneers correct?

A

correct anterior guidance
create canine guidance
palatal erosion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the contraindicationsd for ceramic veneers?

A

Insufficient surface enamel
Pulpless teeth - fragile and will change colour
Unsuitable occlusion - pronounced overbite
Parafunction - bruxism/nail biting
Unsuitable anatomical morphology
Single laminate veneers - difficult to match with
Heavily restored dentition; caries and fillings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What gives the veneer strength?

A

The bond of the glass ceramic to the tooth

by assigning a coupling agent that infiltrates into the silica bonds in the ceramic and forms a bond

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What needs to be checked at the examination and assessment?

A 
The problem
The pt
The OH
The teeth in question 
quantity and quality of enamel 
the occlusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the things that could cause the problem to the teeth leading to the patient wanting veneers?

A

Hereditary - amelogenesis imperfecta
Systemic
Traumatic
Parafunction - bruxism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Could veneers be an option for tetracycline discolouration?

A

Causes banding on teeth
Needs to be very opaque to mask out
Lower anteriors have less bonding surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

If have dead pulp what can be done to prepare for a veneer?

A

Discolouration would show through

Need to do RCT, internal bleaching then can place the veneer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When treatment planning what needs to be considered?

A

OH, caries, restorations
Smile analysis
Occlusal analysis - if on occlusal surface will cause resin to wear and unsupported ceramic to eventually fracture or chip
Must co-incide with veneer margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What needs to be assessed about the face?

A

lips, maxillary and mandibular lip lines

skin colour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is included in a smile analysis?

A

View from front and sides: shape of face, size of lips and visible coronal and gingival levels
Harmony and proportion of cervical line, line of incisal edges , lip line
Tooth colour: Value, hue, chroma and translucency, texture and luster
Tooth shape: size of tooth, incisal edges, contour, assessing triangular tooth shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does occlusion need to be checked during the smile analysis?

A

Analysis of static and dynamic occlusion - models articulated using face bows and records
Spatial arrangement of teeth
Check centric, intercuspal, protrusive, left and right excursions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens if any of the occlusal contacts are on the margin of the veneer?

A

It will chip away and cause the resin to wear and unsupported ceramic will eventually chip and break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the different ways to demonstrate to the patient the proposed aesthetic changes before and after

A

Diagnostic wax up
Direct placement of composite resin with no etch or bond
Temporary composite resin restorations
Resin composite shell or overlay on diagnostic cast
Computer imaging
Demonstration models
Photography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why is replacing veneers not good?

A

First bond gives the best bond
Every time replace there will be some cement left over reducing the bond
Every time it is replaced will lose some enamel - then will need a dentine bonded crown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What needs to be discussed at treatment planning?

A

Evaluate and discuss all options, advantages and disadvntages of each
Informed consent - post op sensitivity, marginal discolouration, fracture and debonding
Short and long term maintenance
Financial implications
Wouldnt want to do till >20 as they wont have enough recession

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why do veneers need to be relpaced?

A

Last 5-10 years, get recession then can see margins

Margins can become stained over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does veneer preps depend on?

A 
Method of fabrication
Occlusion 
Desired asesthetics 
Parafunction 
Presence of enamel at all proposed margins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What can a veneer be made out of?

A 
Resin composite 
or Porcelain (ceramic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the indications for a direct composite veneer?

A

Extensive damage to incisal or buccal surface
Defective restorations
Discolouration non-amendable to bleaching
Mal-aligned teeth
Congenitally deformed teeth
Patient that doesnt have time or finances for indirect porcelain veneer
Where a porcelain veneer would require excessive tooth structure removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the contraindications for direct composite veneer?

A

Inability to obtain: correct shades to blend with adjacent teeth, correct contours, correct surface characteristics, proper isolation
Multiple teeth due to the extensive time and difficulty in achieving consistent shade, contours and surface characteristics

32
Q

What are the advantages of direct composite veneer?

A

Very little or no tooth prep required
Wear similarly to tooth structure and do not cause iatrogenic wear of opposing dentition
Chair-side repairs

33
Q

What are the disadvantages of direct composite veneer?

A

Colour stability - takes in colour from environment but this can be pre-polished and repaired
Result isnt as long lasting as porcelain
Not as strong
Wears more compared to ceramic

34
Q

What is the direct veneer technique?

A

Veeners made by dentist chairside
only one appointment needed
minimal or no preprequired

35
Q

Why may you do a chamfer when doing a direct veneer technique?

A

To avoid ledges around the periphery and can remove some colouring

36
Q

What composite is used for the indirect technique?

A

Colour modifiers

Resin composite; microfilled, hybrid

37
Q

What is the longevity of composite veneers?

A

Frese et al 2013

Restoration showed a functional survival rate of 100%, an overall survival rate of 84.6% after 5 years

38
Q

What is the indirect composite technique?

A

Minimal prep
0.25-0.5mm tooth reduction
Resin cement for cementation
Bonding similar to porcelain veneers

39
Q

What are examples of the systems used for indirect composites?

A 
Artglass
Belleglass
Sculpture 
Targis
Paradigm MZ100 (CAD/CAM)
40
Q

What are the advantages of indirect composite veneer over a direct one?

A 
Reduced polymerisation shrinkage
Get smaller marginal leakage
Less post op sensitivity 
recurrent caries 
staining 
Better control of interproximal contours and contacts - no ledges or catches 
Less technique sensitive
41
Q

When was the porcelain veneer re-introduced?

A

After the introduction of acid-etch technique

In 1980’s the porcelain veneer re-introduced

42
Q

What are the 4 components of the porcelain laminate veneer?

A

A porcelain veneer
An acid-etched enamel surface
A silane coupling agent
A resin cement

43
Q

What are the advantages of porcelain laminate veneer?

A 
Superior aesthetics 
Excellent long-term durability
Strength
Marginal integrity - made to the model
Soft tissue compatibility 
Minimal tooth reduction
44
Q

What are the disadvantages of porcelain laminate veneer?

A 
Time consuming - multiple appointments
Fragility 
Repairing difficult 
Colour matching difficult
Irreversibility 
Inability to trial cement the restoration
45
Q

What are the different porcelain technologies?

A 
Feldspathic - Mirage II
Leucite reinforced - Empress I, Cerinate
Lithium disilicate - Empress II/Emax
Glass infused e.g. InCeram
Cast glass e.g. Dicor
46
Q

Why use CAD/CAM for porcelain?

A

High standard and uniform

47
Q

Why prepare teeth first for a veneer?

A

Stress concentration is less on veneers fitted to prepared teeth
Prep also removes aprismatic and hypermineralised enamel layer which are more resistant to acid etching

48
Q

Why should veneer prep be only into enamel not dentine?

A

To maximise resin bond strength and reduce tensile stress in the porcelain

49
Q

What is the tooth prep for porcelain veneers?

A

Minimal prep and even reduction
0.3-0.5mm mini chamfer
Facial reduction in 2 planes

50
Q

How can you adjust the veneer prep if the incisal edge is in occlusion?

A

Would want more ceramic on the incisal edge to withstand the occlusal forces

51
Q

When may you use the ‘window’ or intra-labial technique for veneer prep?
What is different about this prep?

A

Useful in canine guidance
Class II div II and class III incisor relationship
It is contained all on the labial surface not on the incisal edge
Don’t need a temp restoration

52
Q

What is involved in the long bevel preparation?

A

Keep the length if the incisal edge

Half of the incisal edge has been reduced

53
Q

Why do they need to be temporised?

A

Aesthetics
Sensitivity
Diagnostic - test the contour, shape, length

54
Q

What are the different types of temporaries that can be made?

A

Spot-etch direct build up
Chairside - clear matrix on diagnostic wax up, then spot-etch and pro-temp
Indirectly made composites made in lab

55
Q

When are you more likely to need to temporise the prep?

A

When preps more aggressive and dentine is exposed

They can also serve as provisionals?

56
Q

What type of cement is used and why?

A

Light cured composite luting agent - may want dual cured, less opaque
Share part of applied loading stresses during the masticatory cycle

57
Q

What happens at the try-in veneer stage

A

Try-in before cementation
Using resin luting agent
Use a try-in paste: Water soluble, Matches cement , optical contact
Use veneer carrier as very fragile

58
Q

How do you prepare the veneer for cementation?

A 
Veneer surface treated with HF
Clean the fitting surface of veneer with acetone to remove try-in paste
Rinse and dry
Silane application 
Keep away from light
59
Q

Why treat the veneer with phosphoric acid?

A

improves the bonding strength

60
Q

How much acetone is needed to make sure all try-in paste is removed?

A

40ml Acetone

61
Q

What does the silane coupling agent do?

A

Apply to the internal etched surface
Chemically bonds to ceramic
Makes ceramic surface hydrophobic

62
Q

When would you use a more opaque cement?

A

Discoloured/dark teeth

63
Q

Why use a veneer carrier?

A

Avoids handling and avoids too much pressure during placement
Veneer must be held in 2 planes during initial palatal polymerisation
If veneer not held firmly enough then get suck back

64
Q

What happens if the veneer is not held firmly during initial polymerisation?

A

Suck back occurs causing gaps at the margins

65
Q

What can resin spaces be caused by?

A

insufficient luting resin and incorrect sequence of seating multiple veneers

66
Q

What do you do when finishing the cementation of the veneer?

A

Use floss to remove the excess cement or finishing burs
Check the occlusion
Finish with polishing points

67
Q

Why don’t you want ledges or excess cement?

A

Food trap
Gingival irritation
Recession - then see the margin

68
Q

What are resin spaces caused by?

A

Insufficient luting resin

Incorrect sequence if seating multiple veneers

69
Q

When can you get fracture of the veneer?

A

Unfavourable occlusion
Parafunction
Bonding to existing restorations

70
Q

Apart from fracture why else may a veneer fail?

A

Micro-leakage/marginal staining

Debonding

71
Q

What are the 3 types of veneer fracture?

A

Static
Cohesive
Adhesive

72
Q

What is a static fracture?

A

When segment of veneer fractures but remains on the tooth

Due to excessive loading or polymerisation shrinkage

73
Q

What is Cohesive fracture?

A

Within the body of porcelain due to tensile loads from excessive functional or parafunctional loading
Results in loss of fragment

74
Q

What is Adhesive failure?

A

Failure of bonding interface

Due to weak bond or severe occlusal loading

75
Q

If have a debonded veneer and the luting agent is still on the tooth, what does this mean?

A

Inadequate etching of veneer or no silane coupling agent

76
Q

If have a debonded veneer and the luting agent is still on veneer what does this mean?

A

Problem with bonding materials, placement technique or bonding substrate - more likely when predominately dentine

IRS (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions