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VENEERS
SUBMITTED BY
NESHEENA .V .K
PART 1
PSM DC
2
CONTENT
• Veneers
• Definition
• Indication
• Contraindication
• Type
• Direct veneer technique
• Indirect veneer technique
• Directly applied composite veneer
• Processed composite veneer
• Lumineer
• conclusion
3
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
Indications
• Improve extreme discolorations such as tetracycline staining,
flourosis, devitalized teeth, and teeth darkened from age.
• Repair chipped or fractured teeth.
5
• Closing of diastemas between teeth.
• Ability to lengthen anterior teeth.
• Improve the appearance of rotated or misaligned teeth
6
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
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
• Two basic preparation designs exists for full veneers:
1. Window preparation:
2. Incisal, lapping preparation
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.
9
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
11
12
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
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
• 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.
•Expensive.
•Tooth preparation.
•Highly sensitive technique.
•Sensitivity.
• It has number of limitation
15
Conventional Porcelain Veneers:
• 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
1. Indirectly fabricated veneers are much less sensitive to operator
technique. Indirect veneers are made by a laboratory technician
and are typically more esthetic.
2. If multiple teeth are to be veneered, indirect veneers usually can
be placed much more expeditiously.
3. Indirect veneers typically last much longer than direct veneers,
especially if they are made of porcelain or pressed ceramic.
17
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
cleaning Shade selection isolation Removal of
the defect &
tooth
preparation
.depth is 0.5
to 0.75 mmetching
Restoration of cavity with
composite resin (microfilled)
• Extensive enamel hypoplasia of anterior teeth
• Diastema
• Tetracycline stained teeth
• One or two appointment
• Steps
19
indications
cleaning
Shade selection
Isolation &
gingiva is
retracted
1
2
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
Indirect veneer technique
• Indirect veneer are made of
1. Processed composite
2. Feldspathic porcelain
3. Cast or pressed ceramic
• Two appointment are required
21
• 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
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
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.
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
26
FIRST APPOINTMENT
(Veneer Preparation
Procedure)
Shade Selection
Tooth preparation
Impression
Temporary Veneers
SECOND APPOINTMENT
Remove temporary
Clinical try-in
Cementation
• 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
Labial reduction
Interproximal reduction
Incisal modification
Cervical definition
28
29
Impression
• The retraction cord
should be left in
place if possible
during the impression
• Use a polysiloxane or
polyether material
for the impression
Temporary
Veneers
• They are placed when
necessary or desired
• Hand sculptured
using composite, kept
supragingival and
attached by spot
etching
The laboratory procedures
30
Second Appointment
31
Clinical try-in
Contacts need to be carefully assessed Proximal contacts can be adjusted
Remove temporary
Care must be taken not to damage margin areas of preparations
Cementation
32
Try-in paste allow you
to mask any underlying
color abnormalities and
select cement shade
Apply saline solution to
the internal aspect of
the veneer
Etch, rinse, dry
but do not
desiccate
Apply
primer/adhesive
to the tooth and
lightly air dry
Apply cement to the
internal aspect of the
veneer, seat the veneer,
clean off excess cement,
light cure
Floss contacts and
adjust occlusion.
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
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
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
Before & After
36
37
38
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
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
41

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Dental veneer @

  • 1. 1
  • 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: 1. Window preparation: 2. Incisal, lapping preparation 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. 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. •Expensive. •Tooth preparation. •Highly sensitive technique. •Sensitivity. • It has number of limitation 15 Conventional Porcelain Veneers:
  • 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. 1. Indirectly fabricated veneers are much less sensitive to operator technique. Indirect veneers are made by a laboratory technician and are typically more esthetic. 2. If multiple teeth are to be veneered, indirect veneers usually can be placed much more expeditiously. 3. 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 cleaning Shade selection isolation Removal of the defect & tooth preparation .depth is 0.5 to 0.75 mmetching Restoration of cavity with composite resin (microfilled)
  • 19. • Extensive enamel hypoplasia of anterior teeth • Diastema • Tetracycline stained teeth • One or two appointment • Steps 19 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 1. Processed composite 2. Feldspathic porcelain 3. 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
  • 26. 26 FIRST APPOINTMENT (Veneer Preparation Procedure) Shade Selection Tooth preparation Impression Temporary Veneers SECOND APPOINTMENT Remove temporary Clinical try-in Cementation
  • 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
  • 29. 29 Impression • The retraction cord should be left in place if possible during the impression • Use a polysiloxane or polyether material for the impression Temporary Veneers • They are placed when necessary or desired • Hand sculptured using composite, kept supragingival and attached by spot etching
  • 31. Second Appointment 31 Clinical try-in Contacts need to be carefully assessed Proximal contacts can be adjusted Remove temporary Care must be taken not to damage margin areas of preparations
  • 32. Cementation 32 Try-in paste allow you to mask any underlying color abnormalities and select cement shade Apply saline solution to the internal aspect of the veneer Etch, rinse, dry but do not desiccate Apply primer/adhesive to the tooth and lightly air dry Apply cement to the internal aspect of the veneer, seat the veneer, clean off excess cement, light cure Floss contacts and adjust occlusion.
  • 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
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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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