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DEN304 - IODC > Veneers > Flashcards

Veneers Flashcards

Understand the aesthetic considerations and restrictions of different cases Understand the process of aesthetic treatment planning Learn about the different types of laminate veneers Learn about the different fabrication techniques and materials

1
Q

What is a veneer?

Purpose of veneer

A

Layer of tooth coloured material fabricated by ceramic or composite material

Restore localised or generalised defects and intrinsic discolouration
Improve shape, colour and position

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2
Q

Indications for veneers

A

Colour defects/abnormalities e.g AI
Abnormalities of shape or structure
Malpositioning
Diastema
Missing teeth e.g masking canine as lateral
Lingual laminate veneers to correct guidance
Lengthening

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3
Q

Contraindications for veneers

A 
Insufficient surface enamel for etching and bonding 
Pulpless/fragile teeth - may change colour
Unsuitable occlusion 
Parafunction 
Unsuitable anatomy 
Single veneers - very hard to match 
Heavily restored dentition 
Poor OH
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4
Q

Examination and assessment criteria

A 
Problem 
Patient's opinion 
OH 
Teeth involved 
Quality and quantity of enamel 
Occlusion?
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5
Q

Tx planning

A 
Full history 
Determine causative factors e.g hereditary AI 
OHI
Caries
PD status
Endodontic status
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6
Q

Facial assessment

A

Shape of face, lips, maxillary, mandibular lip lines

Skin colour - changes

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7
Q

Smile analysis

A

View from front and sides
Size of lips
Visible coronal and gingival levels

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8
Q

Tooth colour - things to consider

A 
Hue 
Value 
Chroma
Translucency 
Texture and lustre
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9
Q

tooth shape

A

Size - height : width
Incisal edge
Contour of buccal surface
Assess triangular tooth shape

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10
Q

Occlusion

A

Placement of margins on occlusal marks will cause resin to wear and chip away

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11
Q

Demonstrate the proposed aesthetic changes before and after

A 
Wax up 
Direct placement w'out etch/bond 
Temp composite resin restorations 
Wax up and matrix and protemp 
Resin composite shell/overlay on diagnostic cast
CAD
Demo models
Photography
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12
Q

Evaluate and discuss

A

Adv and Disadv of each option
Informed consent - post op sensitivity, marginal discolouration, fracture, debonding
Short and long term maintenance
Financial issues

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13
Q

Veneer prep depends on

A 
Method of fabrication 
Occlusion 
Desired aesthetics
Parafunction 
Presence of enamel
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14
Q

Veneer can be made of

A

Resin

Porcelain ceramic

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15
Q

Resin/Direct composite veneer - indications

A

Extensive damage to incisal/buccal surface
Defective restoration
Discolouration
Malaligned or mishapen teeth
Lack of taime or finances
Where indirect would require excessive prep

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16
Q

Contrindications to direct composite veneer

A 
Inability to obtain correct shades
Inability to achieve correct contour 
Inability to achieve correct surface characteristics
Inability to isolate
Time consuming if multiple teeth
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17
Q

Advantages of direct CV

A

Little/no tooth prep
Many wear similar to natural tooth - no iatrogenic wear of opposing teeth
Chairside repairs
Can be altered

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18
Q

Disadvantages of direct

A

Colour stability - take on stains
Result not as long lasting as porcelain alternative
Not as strong as ceramic
Wears more compared to ceramic

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19
Q

Technique for direct

A

made chairside
Uses colour modifiers
Resin composites/microfilled/hybrid
Consider minor preparation if build up will change lip line

20
Q

Longevity of Composite veneers

A

Fx survival 100%

Overall survival rate 84.6% after 5 years

21
Q

Indirect technique of COMPOSITE

A

Minimal prep
0.25-0.5mm tooth reduction if needed
Resin cement
Bonding procedure similar to porcelain veneers

22
Q

Advantages of indirect over direct

A

Less polymerisation shrinkage
Less leakage and staining and sensitivity
Physical properties of composite found to improve with more curing
Better control over contacts and contours
Less technique sensitive

23
Q

Porcelain veneers - 4 components - ESSENTIAL

A

Porcelain veneer
Acid-etched enamel surface
Silane coupling agent
Resin cement

24
Q

Advantages of porcelain veneer

A 
Aesthetics 
Durability 
Strength 
Marginal integrity 
Soft tissue compatibility 
Minimal tooth reduction
25
Q

Disadvantages of porcelain veneers

A 
Time consuming
Fragile
Difficult to repair 
Colour matching can be a challenge 
Irreversible 
Inability to trial cement the restoration
26
Q

Porcelain glass ceramics

A

Disilicate

Glass reinforced

27
Q

Veneer considerations

If not prepping?

A

To prep?

If not prepping - reversible, painless, overcontoured, bulky, hygiene, inflammation?

28
Q

Advantages of prep

A

Stress concentration is less
Prep removes aprismatic and hypermineralised enamel which is more resistant to etch
Aim for prep to be completely in enamel to maximise bond strength

29
Q

Tooth prep measurements

A 
Minimal 
0.3 - 0.5 mm mini chamfer 
0.6-0.8 incisal buccal reduction 
Facial reduction in 2 planes 
Special bur kits
30
Q

Types of prep - how to accomodate for occlusive force

A

More prep so provide more ceramic bulk

31
Q

Preparation types

A

Window prep - short of incisal edge
Long bevel - thin incisal edge
Complete coverage

32
Q

Extension of prep over incisal edge

A
  • increases strength
33
Q

Temporisation - important factors

A

Aesthetics

Reduced sensitivity

34
Q

Types of temp

A

Direct composite with spot etching

Chairside - diagnostic wax up

35
Q

Cementation - fx

A

Shared part of applied loading stresses

Luting agent for light cured composite

36
Q

Try in stage - purpose - using what

A

Resin luting agent
Assess fit and aesthetics
Try in paste

37
Q

Preparing veneer

A

Trreat surface with HP

Clean and remove

38
Q

Veneer cementation

A

Must be held in two planes

39
Q

Resin spaces are caused by

A

Incorrect luting

Incorrect seating

40
Q

Failures

A

Fracture due to occlusion, PF, bonding to existing restoration
Microleakage/marginal staining
Debonding

41
Q

3 types of veneer fracture

A

Static
Cohesive
Adhesive

42
Q

Static fracture

and cause

A

Segment of veneer fragments but remains in place

XS load –> loss of fragment

43
Q

Cohesive fracture

and cause

A

Within body of porcelain

Tensile loads from XS functional loading

Results in fracture

44
Q

Adhesive fracture

and cause

A

Failing of bonding interface

Due to weak bond or severe occlusal loading

45
Q

Debonded veneer

A

Determine which interface has failed

If luting agent is still present on TOOTH - etching was inadequate

If luting agent still present on VENEER - problem with bonding/placement/bonding substrate

DEN304 - IODC (58 decks)

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