Erec Eneers: How, When & Why

Cerec Veneers
How, when & why

www.cerecsolutions.com
Dr Brad Wright BDSc (Qld) LLB( Hons)
FFDACLM ISCD CEREC Trainer CEREC Veneers Atlanta Cerec Day October 26 2002
This presentation
This was part of a presentation given at Dr Kennedy’s Atlanta CEREC day on
10/26/2002.
This is given freely in good faith.
The only condition that applies to its receipt is that where any part of it is used,
acknowledgement of the source must be given, and there must be no charge for the
provision of the presentation and any images within it.
Hey I can’t help it – I am a lawyer as well !
Brad Wright Gympie Qld Australia

www.cerecsolutions.com

Veneer Procedure
• Case Selection
• Preparation
• Design
• Shading
• Naturalise / Glaze
• Cementing
• Finishing
Why would you do a CEREC
Veneer ?
Veneers are almost always done to improve aesthetics.

We consider CEREC Veneers because of a balance of
clinical indications and practicalities.
We would only consider CEREC if it is easier better or
faster, or some other practicality………….

Characteristics Of Cerec Veneers
VERY Translucent
Ultimate Shade Control by operator
Characterisation is excellent
Can be time consuming for multiples
Not great for VERY big Value changes
Not great for a smile that is manufactured
Inexpensive to construct
Can be stressful

Characteristics of Laboratory
veneers
Not time consuming
Very Good for multiples
Can be expensive
Can create tension with Technicians where expectations are not met
Little Shade Control by the dentist
Remakes expensive and time consuming
Can accommodate large value changes because of opacity built into
ceramic.

BENEFITS OF CEREC
VENEERS
Fast
No temporary
Have them today
Great Translucency
Great Ability to Individualise
Great Control
Remake is quick
Because you don’t need temporaries,
you can prep dentin without concerns
about sensitivity (Dr. M. Hodish)

DISADVANTAGES OF CEREC
VENEERS
Translucent – must block out
Time Consuming
Individualising can be difficult
Preparations may need to be less
conservative
No temporaries means you have
to get them RIGHT

INDICATIONS For CEREC
Not too great a shade change

Where you have room to block out
Single and double cases
Where tooth symmetry and shape are not at issue

CONTRAINDICATIONS
Large shade and Chroma changes
Multiples, “Chiclet” style
VERY Fussy patients who will take a
lot of time
Where there are issues of Symmetry
and Shape
Where you have a lot of teeth
showing and not a lot of time

PREPARATION
INDICATIONS
Normal porcelain veneer requirements
Thicker if there are shade changes (more
tooth reduction)
Go into the interproximal areas
Finish on enamel

PREPARATION RULES
Butt Joints interproximally
Labial Inciso Chamfer
Flat and smooth as possible
Gingival can be a chamfer also
Think about colour change
Think about labial and proximal
emergence profile

Incisal Edge
The problem is poor palatal margin fit.

This may not be new, but a vary small
inciso-labial chamfer will help

The Camera Problem

Conventional Incisal Wrap Prep

Why this happens

Try this…..

Makes it easier for the Camera

You get this

Instead of this

Also Try this

TECHNIQUES
You can do crowns with the veneer programme, you just
MUST be able to visualise all margins from the labial.
Camera angle is what influences success with all CEREC, no

less with Veneers

Crown vs Veneer – What is the difference ?
Veneer – where occlusion is not absolutely

critical
Crown where occlusion is more of an issue, and
where the dentine enamel walls externally are all
gone
Veneer is quick simple but needs adjusting
Crown is fast complex but needs adjusting

DATABASE VENEER
Simplest Programme to use
Fast Effective
Gives plenty of Ceramic to remove
Must obey certain prep rules
Where you have a freestyle tooth to work on ( so not when
you are doing a row of chiclets)
How much tooth can you add, and when does a veneer
become a crown ?

This is easy…

This is still easy with database

Even this can be done!!! With Veneer !

CORRELATION VENEER
Ideal where you send the patient home with a mock up
veneer
Allows you to copy the labial contour and emergence
profiles as well as the embrasures
Ideal for cases where a copy is required
Can still do large incisal additions, but can need
adjustments

CORRELATION VENEER
ENDOCROWN
Variation on Correlation veneer where endo crown
programme and milling characteristics ensure a well fitting
veneer

SHADING
The biggest problem with CEREC veneers, are
that the shading work done by our technicians
must be done by the dentist.
We have to be as good as technicians are at

shading.
This can be done internally, or externally

INTERNAL
Most commonly with dark teeth,
some extra dentin must be removed so
that an opaque layer can be added.
This is really pre-shading prior to
imaging so that the baseline
characteristics of the tooth are such
that a translucent Cerec Veneer can be
constructed over it.
This includes the cement !

EXTERNAL
Naturalise and glaze with Vita
Akzent and Atmomat Furnace or
similar
This adds the lab feel to a

veneer
It can add 15-20 minutes onto

the procedure

TRY IN
Adjust to seat.
Bond (no etch on Ceramic or tooth) with
flowable
Adjust shape
Polish
Cement before Etch with your cement and
set
Check Colour again

CEMENTATION
Do a try in with your cement of choice –

cured but not bonded. MOST cements give a
significant value shift ( darker) on light curing
!!
As per normal CEREC
Use light or dual cure (I prefer dual cure)

Miscellaneous
Perhaps make a resin provisional where you are to
make a significant shape or length change at the
consultation
If you have to temporise, some flowable is fine if

it is not bonded to the veneer or tooth structure

To conclude..
Be Prepared to give veneers a try – its fun
It is the most underused (except perhaps
Function) of the suite of programmes.
Is very cost effective
Can make a veneer with Cerec and add
porcelain or have your technician
chraracterise them

Thanks
I would like to sincerely thank Dr Jim Kennedy Decatur GA, for the opportunity to
speak at his weekend.
I would like to acknowledge Dr Sam Barr Oneida NY for his help in this presentation.
If it wasn’t for selfless distribution of material on Cerec, many of us would not being
enjoying the success we are.
I would like to thank Mr Geoff Staples of Halas in Brisbane Qld Australia and Mr
Roddy McLeod of Shalfoon in Auckland NZ for their assistance and encouragement.


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Cerec Veneers

How, when & why

Brad Wright Gympie Qld Australia

Dr Brad Wright BDSc (Qld) LLB( Hons)

Veneers are almost always done to improve aesthetics.

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Not too great a shade change

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

The problem is poor palatal margin fit.

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Camera angle is what influences success with all CEREC, no

Dr Brad Wright BDSc (Qld) LLB( Hons)

Veneer – where occlusion is not absolutely

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

We have to be as good as technicians are at

This can be done internally, or externally

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

This adds the lab feel to a

It can add 15-20 minutes onto

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Do a try in with your cement of choice –

Dr Brad Wright BDSc (Qld) LLB( Hons)

If you have to temporise, some flowable is fine if

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

Dr Brad Wright BDSc (Qld) LLB( Hons)

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