Dental veneer @

about dental veneers.its classifications,indications,contraindications,advantages and disadvtages

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2. VENEERS SUBMITTED BY NESHEENA .V .K PART 1 PSM DC 2

3. CONTENT Veneers Definition Indication Contraindication Type Direct veneer technique Indirect veneer technique Directly applied composite veneer Processed composite veneer Lumineer conclusion 3

4. Definition A veneer is a layer of tooth-colored material that is applied to a tooth to restore localized or generalized defect and intrinsic discolorations. (Sturdevant's art & science operative dentistry) typically, veneers are made of directly applied composite, processed composite , porcelain, or pressed ceramic materials. 4

5. Indications Improve extreme discolorations such as tetracycline staining, flourosis, devitalized teeth, and teeth darkened from age. Repair chipped or fractured teeth . 5

6. Closing of diastemas between teeth. Ability to lengthen anterior teeth. Improve the appearance of rotated or misaligned teeth 6

7. Contraindication If little or no enamel is present, full crown should be considered. Certain tooth-to-tooth habits like bruxing or clenching , or other para -functional habits such as pencil chewing or ice crushing. Teeth that exhibit severe crowding . Certain types of occlusal problems such as Class III & end-to-end bites Poor oral hygiene. High caries rate. 7

8. Types Based on extent of tooth involved;- 1.Partial veneers 2.Full veneers Partial veneers are indicated for the restoration of localized defects or areas of intrinsic discoloration. Full veneers are indicated for the restoration of generalized defects or areas of intrinsic staining involving most of the facial surface of the tooth. 8 Window preparation Butt-joint incisal preparation Incisal lapping preparation

9. Two basic preparation designs exists for full veneers: Window preparation: Incisal, lapping preparation 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. 9

10. 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. 10

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13. Based on the type of material employed;- Directly applied composite veneer Processed composite veneer Porcelain or pressed ceramic veneer Based on the mode of fabrication;- 13 Direct veneers Direct partial Direct full Indirect veneers No-prep veneer Etched porcelain veneer Pressed ceramic veneer

14. composite veneers Advantages One visit procedure Less expensive Repair potential Chair-side control of the anatomy Minimal irreversible loss of tooth structure. Disadvantages Tend to discolor Wear out quickly Marginal staining Shade matching difficulty Often require repair and replacement 14

15. Very conservative. Offer better inherent color and natural look. Tissue tolerance is excellent. Less staining. The bond of etched porcelain veneer to enamel is stronger than other. Wear and abrasion resistance is high. The aesthetics are better than any other veneer material. Porcelain veneer allow transmission of light. advantage Expensive. Tooth preparation. Highly sensitive technique. Sensitivity. It has number of limitation 15 Conventional Porcelain Veneers : Disadvantage

16. 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: 16

17. 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. 17

18. Direct veneer techniques Are indicated for the restoration of localized defects or areas of intrinsic discoloration These defect can be restore in one appointment with light-cured composite. Steps 18 Direct partial veneers Direct full veneers Direct partial veneers cleaning Shade selection isolation Removal of the defect & tooth preparation .depth is 0.5 to 0.75 mm etching Restoration of cavity with composite resin ( microfilled )

19. Extensive enamel hypoplasia of anterior teeth Diastema Tetracycline stained teeth One or two appointment Steps 19 Direct full veneers indications cleaning Shade selection Isolation & gingiva is retracted 1 2

20. 20 Window Tooth preparation with coarse round diamond bur .depth is 0.5-0.75 mm mid facially & tapering down to a depth of 0.2-0.5 mm along gingival margin After etching,rinsig, & drying procedure. applied the composite . 3 4 5

21. Indirect veneer technique Indirect veneer are made of Processed composite Feldspathic porcelain Cast or pressed ceramic Two appointment are required 21

22. Composite Veneers One visit procedure Less expensive Repair potential Chair-side control of the anatomy Minimal irreversible loss of tooth structure Porcelain Veneers Esthetic stability Stain resistant Stronger and durable Gum tissue tolerates porcelain well The color of a porcelain veneer can be selected such that it makes dark teeth appear whiter. Veneers offer a conservative approach to changing a tooth's color and shape. 22

23. Processed composite veneers First Appointment *Window preparation recommended due to limited bond strength. *Incisal lapping if incisal defect. * Intraenamel preparation. *Elastomeric impressions. *No temporization . 23

24. 24 Second Appointment Evaluate fit of veneer. Tooth side of veneer (pre etched) is primed. Tooth etched, rinsed and dried. Adhesive is applied but not cured. Adhesive cement applied. Veneer placed and excess cement removed. Light cured for 40-60sec facial & lingual. * Check for fit with no.2 explorer .

25. Etched porcelain veneer A Etched porcelain veneer is a thin piece of porcelain that is bonded to the front of a tooth. Porcelain is a durable, translucent, strong, natural-looking, and beautiful material. The only difference in this procedure for porcelain veneers from the composite veneers is the need to condition the internal surface of each veneer with a silane primer just before applying the resin-bonding agent 25

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27. Labial reduction - Interproximal reduction Incisal modification - Cervical definition Place a horizontal facial depth cut, it is usually 0.3 mm from proximal line angle to proximal line angle. Make this depth cut at the junction of the cervical and middle one-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 diamond bur from the papilla tip toward 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 27 Tooth preparation

28. Labial reduction Interproximal reduction Incisal modification Cervical definition 28

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30. The laboratory procedures 30

31. Second Appointment 31

32. Cementation 32

33. Lumineer Difference between Lumineers and standard porcelain veneers 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. 33

34. Advantage 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 that the impressions are made. • Lumineers bond directly to the tooth , making the bond very strong . They are also very long-lasting- up to twenty years or longer. • Lumineers are a reversible procedure . 34

35. The LUMINEERS Minimal Contouring Technique requires slight modification of the enamel but never touches dentin during LUMINEERS placement. Only0 .3 mm-0.5 mm enamel is removed, causing no sensitivity for the patient and therefore no need for any anesthesia. 35

36. Before & After 36

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39. Conclusion This procedure is becoming more common in dental offices because everyone want a great smile. It is a great way to change a smile that shows yellowed, stained teeth into one that make you look fantastic. But remember veneers are not for everyone, & if your teeth are not strong enough you will not be recommended to have the dental veneers applied. 39

40. 40 BIBLIOGRAPHY Sturdevant's art & science operative dentistry Essential of operative dentistry I Anand Sherwood Textbook of operative dentistry sumeeta sandhu Dr. Lazare's The Patient's Guide To Dentistry

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