Whether you are placing one veneer or several to create the appearance of a wonderful symmetrical smile, your veneer prep can make or break this aesthetic procedure—literally and figuratively.
However, other considerations go into veneer prep design. We look at a few, including veneer types, why veneer prep is essential, the three types of veneers most clinicians use, and a step-by-step guide for getting teeth prepped for veneers. Also you need a quality lab to partner with for the height of patient satisfaction.
For the most part, dental veneers are made of composite resin or porcelain. However, other materials are also available.
Types of veneers
- Composite resin: Comprised of a methacrylate resin and an inorganic filler, like glass, resin veneers are the most affordable option.
- Porcelain: Porcelain veneers are mostly glass but without a clearly defined crystal structure and are stronger and more durable than composite resin.
- Lithium disilicate: Lithium disilicate are ceramic veneers that combine the metal lithium with silicon, giving it a translucency that matches surrounding dentition.
- Zirconia: Another ceramic material, zirconia (zirconia oxide) is opaquer than lithium disilicate, and is strong, stain resistant, and biocompatible.
Why is veneer preparation important?
Veneer preparation is essential for success with the treatment, for several reasons, including:
- It ensures that the teeth thickness isn’t increased after veneers are affixed.
- It facilitates a stronger bond, particularly when placed upon prepped enamel within two weeks of the preparation.
- It allows for decay removal or replacing composite fillings if necessary.
- It lets clinicians use a thicker veneer, which is especially important when masking discoloration.
- It permits planning of the veneer placement to hide the edges and prevent it from contacting other teeth.
- It presents the opportunity to shorten the incisal edge if the veneer prep design wraps the edge of the tooth.
Three basic preparation groups
Dentistry groups veneers by the amount of reduction required. The three basic preparation groups of veneers include:
Minimal preparation veneers
As the name implies, this preparation design involves removing the least amount of tooth structure, in the .3 to .5mm range, and usually only enamel. These are sometimes referred to as no-prep veneers, which are much thinner than conventional veneers.
Classic preparation veneers
This preparation removes more tooth structure, usually .5mm or more to make room for a thicker veneer. Conventional thickness porcelain veneers employ this preparation.
More aggressive preparation veneers
In some cases, where there is trauma or the patient has a significant shade change goal, removing up to 1.5 mm might be required. These preparations can get past enamel and into the dentin, which will require the appropriate adhesive later when placing veneers.
How do you prepare for veneers?
Preparation design depends on many things, including the space needed, working thickness, the patient’s enamel volume, the enamel’s outside edge, and dentin exposure. Following is a simplified step-by-step overview on veneer prep.
Initial examination
The initial examination gathers information and establishes the desired result for the patient’s veneer case. Assess the patient’s oral health to ensure they can proceed with treatment. Also, consider the patient’s teeth position and the cosmetic issues to address.
Prepare teeth
After defining the goals, begin veneer preparation. Removing as little enamel as possible ensures a predictable bond, but some case goals require a prepration design that removes more enamel and gets into the dentin.
Resin preparation guides can transfer the established treatment goals and facilitate the tooth’s minimally invasive prep. Also, mark the areas for minimally invasive reduction with a pencil or waterproof marker. Then prepare the marked enamel with the appropriate reduction tools.
Some additional considerations:
- For classic preparation veneers, address interproximal spaces with a more aggressive reduction than the facial surface and include a clearly marked marginal line.
- If there is a horizontal finish line, decrease the reduction of the buccal enamel as you move from the incisal edge to the margin to allow the technician to mask the transition lines with the veneer.
- When placing additional veneers, design a prep with a feather edge to give the technician more leeway meet the treatment goals with the veneer design.
Take impressions
Next, take impressions of the prepared teeth. Place a retraction cord (we suggest the double retraction cord technique) for veneers that have edges under the gumline, then remove it before taking the impression. Then, send the STL file or the model to the lab for design, wax up and fabrication.
Place temporary veneers
If the veneer prep design requires a significant tooth reduction, protect against sensitivity with temporaries. Choose the appropriate size and shape and affix with temporary cement. Be sure to educate the patient about how to care for the temporaries.
Place permanent veneers
Before placing final restorations, seat the veneer without cement and make any adjustments to perfect the fit and shape. Consider which cement might enhance the shade matching by trying in using the cement’s trial paste.
Once satisfied with the size, shape, and cement, clean and prepare the tooth surface for final cementation. Be sure to get confirmation the patient is satisfied, too.
Finally, initiate the process for your adhesive system and clean away any excess adhesive. Make any final adjustments by trimming and polishing. Then evaluate the patient’s bite to ensure that is in proper form after final veneers placement.
Final notes on veneer prep
Getting teeth prepped for veneers starts with excellent veneer prep design. Veneer prep has to consider many factors to set up a veneer case for success. For a digital lab partner that can help you create ideal veneers please contact the team at Dandy with questions about veneer preparation or click here to learn about our many restorative services.
Sources
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Lithium Disilicate: What Is It? | Colgate® (2023). Available at: https://www.colgate.com/en-us/oral-health/fillings/lithium-disilicate-what-is-it# (Accessed: 7 June 2023).
Zirconia Veneers & Lumineers – Prices, Advantages Dental Treatment Guide, Dental-treatment-guide.com. Available at: https://www.dental-treatment-guide.com/veneers/zirconia-veneers (Accessed: 7 June 2023).
The porcelain veneers procedure- A guide to the steps of the process. (2023). Available at: https://www.animated-teeth.com/porcelain_veneers/t3_porcelain_veneers_how.htm#ultra-thin.placement (Accessed: 9 June 2023).
Myth vs. Realities: Two Viewpoints on Prepared Veneers and Prep-Less Veneers (2023) Aacd.com. Available at: https://aacd.com/proxy.php?filename=files/Dental%20Professionals/jCD/Vol.%2027/Issue%202/27-2lesagewells.pdf (Accessed: 14 June 2023).
Veneers: What Are Dental Veneers? Cost, Procedure & Advantages (2023). Available at: https://my.clevelandclinic.org/health/treatments/23522-dental-veneers (Accessed: 14 June 2023).
How are Teeth Prepped for Veneers? (2023). Available at: https://www.newmouth.com/blog/teeth-prepped-for-veneers/ (Accessed: 6 June 2023).
Tooth preparation: current concepts for material selection (2021). Available at: https://pocketdentistry.com/tooth-preparation-current-concepts-for-material-selection/ (Accessed: 14 June 2023).