Veneer - Part 1 Flashcards
First step in veneer process?
Finding out what pt doesn’t like: how long had problem, why has it happened, improved/ worsened
How problem affecting QoL
What decisions must be made by dentist?
- Any alternative tx - orthodontic/ crowns
- Pre-tx tx - bleaching, restorations
- Which veneer prep
What is a veneer?
Layer of tooth-coloured material that is applied to a tooth to restore localised or generalised defects
Improve: colour, shape and position
Conservative and aesthetically pleasing
What are indications for a veneer?
Abnormalities of colour: amelogenesis imperfecta, fluorosis
Abnormalities of shape: atypical shape, microdontia
Abnormal structure: dysplasia, erosion, attrition
Diastema
Malpositioned teeth
Missing teeth - camouflage
Contraindications for a veneer?
Insufficient surface enamel Pulpless teeth Fragile teeth Unsuitable occlusion - pronounced overbite Unsuitable morphology - triangular teeth Single veneer - difficult to match Heavily restored Poor OH
What is needed to formulate a tx plan?
Listen to pt describe aesthetic problem
Take full hx relating to the problem
Determine causative factor: hereditary, systemic, traumatic, parafunction
When can palatal veneers be used?
Correct anterior guidance, create canine guidance, if palatal erosion
What should be included in detailed clinical exam?
Perio and endo status
OHI
Smile analysis
Occlusal analysis
Why should skin colour be taken into account?
Veneer that looks bright and high in value against tanned skin will look more yellow and lower in value as skin becomes lighter
What is included in smile analysis?
View from front and side: shape of face, size of lips
Harmony and proportion
Tooth colour
Tooth shape: size (tooth:width), incisor edge, contour
How to assess occlusion?
Occlusal movements should be marked
Veneer margin must not coincide with these marks - cause resin to wear and unsupported ceramic to break
How to tx plan in stages?
- Demonstrate proposed aesthetic changes
- Diagnostic wax-up (use matrix and protemp)
- Direct placement composite - w/o etch
- Computer imaging - Evaluate and discuss all tx options
- Adv/disadv each option
- Informed consent
- Maintenance
- Finance
What should be included to gain informed consent?
Post-op sensitivity Marginal discolouration Fracture Debond Maintenance Finance All tx options - adv and disadvantages
