Veneers Flashcards
describe direct composite veneers
microfill, microhybrid, nanohybrid, or hybrid composite directly bonded to the anterior and proximal surfaces of the anterior teeth
what are the strengths of direct composite
excellent bond strength due to a direct bond of composite to enamel; excellent esthetics; easy to repair; require only one visit to place
what are the weaknesses of direct composite veneers
- will stain over time
- prone to chipping and finning
- short life expectancy (excellent for teens and young adults)
- not as strong as porcelain
what are the 3 types of porcelain veneers
- cast ceramic (Dicor)
- feldspathic porcelain (mirage/fortress)
- pressed porcelain (Empress)
describe feldspathic porcelain (mirage/fortress)
most often used
- can use different shades of porcelain with in same veneer, easy to characterize
describe pressed porcelain
- bulkier
- requires more tooth reduction, excellent marginal flush
what are the strengths of veneers
- excellent esthetics
- high bond strength to enamel
- contour and shade controlled by lab
- excellent margins
- low wear rate
what are the weaknesses of veneers
- multiple appointments necessary
- more tooth preparation required
- veneers fragile prior to cementation
- most expensive; difficult to repair; hard to replace one veneer
what should be considered in patient selection
- good oral hygiene
- periodontal health
- reasonable patient expectations
- limited anterior restorations
- all other tx plan items completed
what are the indications for veneers
- intrinsic staining
- extrinsic staining
- enamel hypoplasia
- agenesis of lateral incisor
- diastema closure
- slight rotation or misalignment of teeth
what are the contraindications for veneers
- heavy bruxism
- severe anterior crowding or tooth rotation
- poor oral hygiene
- oral habits/piercings
- contact sports
- limited available enamel for bonding
how should you anesthetize with veneers
avoid if possible, sensitivity of dentin will indicate when tooth is over prepared
what preliminary impression is taken
alginate or PVS taken to fabricate temporaries
when are shades selected for veneers
taken 2 weeks post any bleaching procedures; should be taken in natural or color corrected lighting
shades can be taken of what areas
gingival, body and incisal areas of tooth
describe the prep for a veneer
- place depth guides - 0.5-0.75mm reduction
- three plane reduction- maintain proper contour of labial surface
- blend depth cuts to uniform finish
- gingival finish- chamfer finish placed at gingival crest
- interproximal - prep extended to but not beyond contact area, avoid undercuts
what are the 3 different types of incisal preparations
- lingual finish
- overlap
- incisal
describe the lingual finsih
incisal edge is onlayed with a deep chamfer finish on lingual
describe the overlap
lingual finish with a butt joint margin; entire edge replace with porcelain
describe the incisal finish
margin finishes at incisal edge does not extend to lingual
be careful of producing undercut between:
gingival and lingual margins
what is the sequence of veneer prep
- prep tooth
- retraction cord
- check for adequate lingual clearance and adequate reduction of facial enamel, all margins should be in interproximal areas
- wet and remove retraction cord if it obscures gingival margin
- impression can be taken using a crown and bridge quality impression material
- provisional fabricated when necessary using acrylic and bonded in place using the spot etch technique
describe how to place retraction cord
place non impregnated cord, then lower gingival margin to new gingival crest with a chamfer finish
porcelain veneers returned from the lab etched with:
hydrofluoric acid
what should you do when veneers get back from lab
- inspect for fractures, chips and fit on the dies
- place veneers on teeth with try in paste found in cementation kit, water can also be used
describe the cementation process of veneers
- seat veneers in pairs starting with central incisors
- adjust contacts if necessary to help seat veneers
- clean excess try in paste from margins with a cotton roll
- evaluate shade and appearance with patient in natural or color corrected lighting
- remove and clean try in paste from the inner surface of the veneer
- etch (only to clean surface) and apply silane (coupling agent) to inner surface of the veneers
- pumice, rinse, and dry surface of teeth to be bonded (two at a time)
- place non impregnated retraction cord to control gingival fluids
- etch, rinse and dry teeth
- place mylar strips between appropriate teeth
- apply bonding agent to inner surface of the veneer and surface of the teeth
- place a layer of resin on inner surface of veneer and immediately place on tooth with light pressure; be careful not to trap air under veneer
- remove excess cement with a dry cotton roll and the tip of an explorer
- cure veneers for 40 seconds from the buccal and 40 seconds from the lingual
- use a scaler to gently break excess cement from margins where possible
- use the same procedure to cement the remaining veneers
what are the additional finishing techniques/things
- finishing strips
- esthetics or sof-lex discs
- rubber porcelain polishing points (Dialite) only at margins
- polishing paste and rubber cup
what are the final finishing steps
- adjust the occlusion after veneers are totally light cured
- avoid excessive chewing forces for 24 hours to let silane bond mature
why should you not adjust occlusion of restorations prior to cementation
veneers are brittle and will crack
when should patient return after veneer cementation and what do you look for
return in one week to adjust restorations, check for gingival irritation and check for any overlooked cement
