DENTAL VENEERS

FATHIMA SHAMIN
FINAL YEAR PART I
GDC TRISSUR
CONTENTS

• Definition
• Indications
• Contraindications
• Types
• Direct veneer techniques
• Indirect veneer technique
• Tooth preparation
• Lumineer
• Conclusion
• Reference
DEFINITION

• A veneer is a layer of tooth-coloured material that is applied to a

tooth to restore localised or generalised defect and intrinsic
discolouration.
• Typically veneers are made of directly applied composite,
processed composite, porcelain or pressed ceramic materials.
INDICATIONS

• Improve extreme discolouration such as tetracycline staining,

fluorosis, devitalised teeth and teeth darkened with aging.
• Repair chipped or fractured teeth.
• Closing of diastema between teeth
• Ability to lengthen anterior teeth
• Improve the appearance of rotated or misaligned teeth
 CONTRAINDICATIONS

• If little or no enamel is present, full crown should be considered.

• Tooth habits like bruxism or clenching, or other para functional
habits such as pencil chewing or ice crushing.
• Teeth that exhibit severe crowding.
• Occlusal problems such as class III and end to end bites
• Poor oral hygiene
• High caries rate
TYPES

• Based on extent of tooth involved

1. Partial veneers
2. Full veneers
• Window preparation
• Butt-joint incisal preparation
• Incisal lapping preparation
• Partial veneers are indicated for the restoration of localised defects or areas of intrinsic
discolouration.
• Full veneers are indicated for the restoration of generalised defects or areas of intrinsic
staining involving most of the facial surfaces of the tooth.
 FULL VENEERS

1. Window preparation
• It is recommended for most direct and indirect
composite veneers.
• this intraenamel design preserves the functional
lingual and incisal surfaces of the maxillary anterior
teeth , protecting the veneers from significant occlusal
stress.
• By using a window preparation, the functional
surfaces are better preserved in enamel.
2. Incisal- lapping preparation
• it is indicated when the tooth being veneered needs
lengthening or when an incisal defect warrants
restoration.
• This design is used frequently with porcelain
veneers because it not only facilitates accurate
seating of the veneer on cementation but it also
allows for improved esthetics along the incisal edge.
• Based on the type of material used
• Directly applied composite veneer
• Processed composite veneer
• Porcelain or pressed ceramic veneer
• Based on the mode of fabrication
1. Direct veneers. 2. Indirect veneers
• direct partial • No prep veneer
• direct full • Etched porcelain veneer
• Pressed ceramic veneer
COMPOSITE VENEERS

ADVANTAGES DISADVANTAGES
• One visit procedure • Tend to discolour
• Less expensive • Wear out quickly
• Regular potential • Marginal staining
• Chair side control of the anatomy • Shade matching difficulty
• Minimal irreversible loss of tooth structure • Often require repair and replacement
CONVENTIONAL PORCELAIN VENEERS

ADVANTAGES DISADVANTAGES
• Very conservative • Expensive
• Offer better inherent colour and natural • Highly sensitive technique
look
• Sensitivity
• Excellent tissue tolerance
• Tooth preparation
• Less staining
• Strong bonding
• Better esthetics
• When only a few teeth are involved or when the entire facial surface is not faulty (i.e partial
veneers) directly applied composite veneers can be completed chair side for the patient in one
appointment.
• Indirect veneers require two appointments but typically offer three advantages over directly
placed full veneers as follows
• indirectly fabricated veneers are much less sensitive to operator technique. Indirect veneers are
made by a laboratory technician and are typically more esthetic
• if multiple teeth are to be veneered indirect veneers usually can be placed much more
expeditiously
• indirect veneers typically last much longer than direct veneers, especially if they are made of
porcelain or pressed ceramic.
DIRECT VENEER TECHNIQUE

DIRECT PARTIAL VENEER

• Are indicated for the restoration of localised defects or areas of intrinsic discolouration
• These defect can be restored in one appointment with light cured composite
• Steps: cleaning —> shade selection—> isolation —> removal of the defect and tooth
preparation depth is 0.5 to 0.75mm —> etching —> restoration if cavity with composite
resin(microfilled)
DIRECT FULL VENEERS
• Indications
• extensive enamel hypoplasia of anterior teeth
• diastema
• tetracycline stained teeth
• One or two appointments
• Steps:
1. Cleaning
2. shade selection
3. isolation and gingiva is retracted
4. Window tooth preparation with course round diamond bur. Depth is 0.5 to 0.75mm mid facially
and tapering down to a depth of 0.2 to 0.5mm along gingival margin.
5. After etching, rinsing and drying procedure
INDIRECT VENEER TECHNIQUE

• Indirect veneers are made of

1. Processed composite
2. Feldspathic porcelain
3. Cast or processed
• Two appointments are required
First appointment Second appointment

Shade selection Remove temporary

Tooth preparation Clinical try in

Impression Cementation

Temporary veneers
TOOTH PREPARATION

• Labial reduction
• Interproximal reduction
• Incisal modification
• Cervical definition
• Place a horizontal facial depth cut. It is usually 0.3mm from proximal line
angle to proximal line angle. Make this depth cut at the junction of the
cervical and middle third of the facial surface of the tooth.
• Paralleling the entire gingival margin, prepare a definitive chamfer finish line.
• Continue the definitive chamfer finish line with a diamond bur from the
papilla tip towards the incisal edge on both the mesial and distal proximal
surfaces
• The facial depth cuts are removed with the diamond bur and the long axis of
the diamond bur is rolled into the proximal chamfer area to eliminate any
sharp line angles.
• Impression
The retraction cord should be left in place if possible during the impression.
It is best to use a polysiloxane or polyether material for the impression since multiple pours are
often needed for the laboratory procedures
Placing soft wax in the lingual embrasures prior to taking the impression will minimise tearing of
the impression in these areas
• Temporary veneers
If they are necessary or desired they are hand sculpted using composite, kept supra gingival out of
heavy occlusion and attached by spot etching the enamel in the center of the tooth away from any
margins
SECOND APPOINTMENT

• Remove temporary

Care must be taken not to damage margin areas of preparations

• Clinical try in

Contacts need to be carefully assessed.

Proximal contacts can be adjusted
LUMINEER

• Difference between lumineers and standard porcelain censers

• The main difference is that lumineers are made from a special patented cerinate porcelain
that is very strong but much thinner than traditional laboratory fabricated veneers. Their
thickness is comparable to contact lenses.
ADVANTAGES

• Lumineers can be placed on the teeth without removal of the tooth structure.
• Patients can receive their veneers quickly usually within two weeks from the date of
impression taken
• Lumineers bond directly to the tooth, making the bond very strong. They are also very
long lasting upto twenty years or longer
• It is a reversible procedure
CONCLUSION

• Dental veneers are an ideal option for people looking to enhance the look of their smile
• It is a great way to change a smile that shows yellowed stained teeth and makes it appear
esthetic
REFERENCE

• Sturdevant’s arts and science operative dentistry

• Essential of operative dentistry I Anand Sherwood
• Textbook of Operative Dentistry Sumeeta Sandhu