*DENTAL VENEER…

((Dr.Hussam Albarraq))
TABLE OF
CONTENTS:

1)what’s the dental veneer.................

2) Comparison between a porcelain-
metal dental crown, an all-porcelain
dental crown and a porcelain veneer
laminate…………………………………………
3) Medical uses………………………………..
4) Indications……………………………………
5) Contraindications………………………….
6) Classification………………………………..
7) Methods of production…………………
8) Types of veneer preparations………..
9) Current Veneer Technologies………..
10) Alternatives…………………………………
11) According to the American Dental.
Association………………………………………
12) Porcelain Veneers………………………
13) Steps to place porcelain veneers…
14) Composite resin veneers……

…………………………………
1)what’s the dental veneer????
In dentistry, a veneer is a layer of material placed
over a tooth. Veneers can improve the aesthetics of
a smile and protect the tooth's surface from
damage……..

2) Comparison between a porcelain-

metal dental crown, an all-porcelain
dental crown and a porcelain veneer
laminate:
There are two main types of material used to
fabricate a veneer: composite and dental porcelain.
A composite veneer may be directly placed (built-up
in the mouth), or indirectly fabricated by a dental
technician in a dental lab, and later bonded to the
tooth, typically using a resin cement. Usually used
for treatment of adolescent patients who will
require a more permanent design once they are fully
grown. The lifespan of a composite veneer is
approximately 4 years.[1] In contrast, a porcelain
veneer may only be indirectly fabricated. A full
veneer crown is described as "a restoration that
covers all the coronal tooth surfaces (Mesial, Distal,
Facial, Lingual and Occlusal)"[citation needed].
Laminate veneer, on the other hand, is a thin layer
that covers only the surface of the tooth and
generally used for aesthetic purposes. These
typically have better performance and aesthetics
and are less plaque retentive...

…...................................

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3) Medical uses:
Veneers are a prosthetic device, by prescription only,
used by the cosmetic dentist. A dentist may use one
veneer to restore a single tooth or veneer with high
quality that may have been fractured or discolored,
or in most cases multiple teeth on the upper arch to
create a big bright "Hollywood" type of smile
makeover. Many people have small teeth resulting in
spaces that may not be easily closed by
orthodontics. Some people have worn away the
edges of their teeth resulting in a prematurely aged
appearance, while others may have malpositioned
tooth/teeth that appear crooked. Multiple veneers
can close these spaces, lengthen teeth that have
been shortened by wear, fill the black triangles
between teeth caused by gum recession, provide a
uniform color, shape, and symmetry, and make the
teeth appear straight... Dentists also recommend
using thin porcelain veneers to strengthen worn
teeth... It is also applied to yellow teeth that won't
whiten. Thin veneers are an effective option for
aging patients with worn dentition. In many cases,
minimal to no tooth preparation is needed when
using porcelain veneers.

When preparing, in between prep and fit

appointments of the veneer, you can make
temporaries, usually out of composite. These are not
normally indicated but can be used if the patient is
complaining of sensitivity or aesthetics.. According
to a leading Beverly Hills Cosmetic Dentist,
temporaries are really important to design and
finalize the aesthetics of the final veneers.
Temporaries help patients and the dentist decide on
the right color, length and shape of the veneers....

…………………………………..………….………………

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4) Indications:
Discoloured teeth, malformed teeth, enamel
hypoplasia (not enough enamel), enamel
hypocalcification (enamel not fully mineralised),
fluorosis, tetracycline staining, non-vital tooth
discolouration, malposition, enamel fractures,
enamel loss by erosion, modify shape of tooth...

………………………………………………………

5) Contraindications:
In a controversial opinion, Dr. Michael Zuk, a
Canadian DDS, profiles in his opinion and problems
of overuse of porcelain veneers by certain cosmetic
dentists in 'Confessions of a Former Cosmetic
Dentist'. He suggests that the use of veneers for
'instant orthodontics' or simulated straightening of
the teeth can be harmful, especially for younger
people with healthy teeth. Leading dentists caution
that minor superficial damage or normal wear to the

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teeth is not justification for porcelain or ceramic
veneers. This is because the preparation needed to
apply a veneer may in some cases destroy 3–30% of
the tooth's surface if performed by an inexperienced
dentist. It has been found that after 10 years, 50% of
veneers are either displaced, need re-treatment, or
are no longer in satisfactory condition...

Some cosmetic dentists may push unnecessarily for

prosthodontic treatment in adolescents or young to
middle-aged adults who have otherwise healthy
teeth that only necessitate whitening or more
routine cleaning. As preparation for veneers requires
shaving down the tooth in some cases, sensitivity
and decay may become a problem if this procedure
is not properly performed. In addition, a veneer's
maintenance cost can also be prohibitive for many
individuals. Veneer placement should be limited to
individuals with significant aesthetic problems, such

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as badly cracked or broken teeth, that do not meet
the requirements for a crown or full replacement…

Additional contraindications include but are not

limited to the following: poor oral hygiene,
uncontrolled gingival disease, high caries rate,
parafunction, no enamel, unreasonable patient
expectations, large existing restorations....

…………………………………….

6) Classification:
There are different types of classification for
veneers. One of the recently suggested veneer
classification (2012) is called Nankali Veneer
Classification and divides the veneers as follows:
Labial Surface Coverage

a) No incisal involvementb) Feathered incisal edgec)

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Incisal overlap

Interproximal preparations

a) No contact point involvementb) Contact point

levelc) Passed contact point…

…………………………………

7) Methods of production:
a) Indirect veneersb) Direct veneers

Materials

a) Ceramicb) Lithium disilicate (very thin and

relatively very strong porcelain)c) Da Vinci (Very thin
porcelain)d) Mac (High resistance to stains and
relatively strong)e) Acrylic (No longer in use for
quality work)f) Compositeg) Nano Ceramic..

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8) Types of veneer preparations:
There are four basic preparation designs for
porcelain laminate veneers;[8]

a) Window

b) Feather

c) Bevel

d) Incisal Overlap

Recent technological advances have been made,

which allow the construction of ultra-thin porcelain
laminate veneers. These veneers require only very
modest, or in some instances, no reduction of the
tooth structure. There are often referred to as "non-
prep" veneers….

……………………………………

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9) Current Veneer Technologies:
a) Lumineers

b) Smile Infinity®

………………..

10) Alternatives:
In the past, the only way to correct dental
imperfections was to cover the tooth with a crown.
Today, in most cases, there are several possibilities
from which to pick: crown, composite resin bonding,
cosmetic contouring or orthodontics.

Non-permanent dental veneers, which are molded

to existing teeth, are a feasible option as well. These
dental veneers are removable and reusable, and are
made from a flexible resin material. Do-it-yourself
kits are available for the impression-taking process,

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and then the actual veneers are made in a lab and
sent to the wearer through the mail.[citation
needed]

Veneers were invented by California dentist Charles

Pincus in 1928 to be used for a film shoot for
temporarily changing the appearance of actors'
teeth.[9] Later, in 1937 he fabricated acrylic veneers
to be retained by denture adhesive, which were only
cemented temporarily because there was very little
adhesion. The introduction of etching in 1959 by Dr.
Michael Buonocore aimed to follow a line of
investigation of bonding porcelain veneers to etched
enamel. Research in 1982 by Simonsen and
Calamia revealed that porcelain could be etched
with hydrofluoric acid, and bond strengths could be
achieved between composite resins and porcelain
that were predicted to be able to hold porcelain
veneers on to the surface of a tooth permanently.
This was confirmed by Calamia in an article
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describing a technique for fabrication, and
placement of Etched Bonded Porcelain Veneers
using a refractory model technique and
Horn describing a platinum foil technique for veneer
fabrication. Additional articles have proven the long-
term reliability of this technique....

Today, with improved cements and bonding agents,

they typically last 10–30 years. They may have to be
replaced in this time due to cracking, leaking,
chipping, discoloration, decay, shrinkage of the gum
line and damage from injury or tooth grinding. The
cost of veneers can vary depending on the
experience and location of the dentist. In the US,
costs range anywhere from $1000 a tooth upwards
to $3000 a tooth as of 2011. Porcelain veneers are
more durable and less likely to stain than veneers
made of composite.

……………………………….

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11) According to the American Dental.
Association:
Dental Veneers..
If you want to improve your smile, dental veneers
are a simple option. Veneers are thin coverings that
are placed over the front (visible) part of the tooth.
They look like natural teeth. Veneers can be used to
correct a wide range of dental issues, such as:

teeth that are stained and can’t be whitened by

bleaching

chipped or worn teeth

crooked or misshapen teeth

uneven spaces or a large gap between the upper

front teeth

Veneers are made of either porcelain or composite

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resin material. Your dentist will help you choose the
material that is best for you. Each type of veneer has
its own benefits….

……………………………………………………

12) Porcelain Veneers:

A porcelain veneer is a thin shell that is custom-
made to fit on the tooth.
Benefits of porcelain veneers:
they are strong and long-lasting
they have a natural-looking surface
less tooth enamel needs to be removed than with a
crown or cap
they don’t stain easily..

A ceramic veneer is placed

After placement

…………………………………….………….

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13) Steps to place porcelain veneers:

To prepare the teeth, the dentist usually removes a

small amount of enamel from the front and sides of
the teeth. This makes room for the veneers so that
your teeth look natural.

The dentist makes an impression, or mold, of the

prepared teeth. The dentist also decides on the
veneer shade that will be best for your smile.

The impression is sent to a dental lab that custom-

makes the porcelain veneers to fit your teeth. This
may take several days. The dentist may give you
temporary veneers to wear in the meantime.

At the next visit, the dentist places the veneers on

the teeth to check the fit and shape. After any
adjustments, the teeth are cleaned and the veneers

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are bonded to the tooth.
Further changes may be made at a later
appointment.

14) Composite resin veneers:

A composite resin veneer is made from a tooth-
colored filling material bonded to the tooth.

Benefits of composite resin veneers:

usually less tooth enamel needs to be removed than

for crowns or porcelain veneers

may mean fewer visits to the dentist—sometimes

these veneers take just one visit

cost less than porcelain veneers

are easy to fix if they get damaged; although

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composite veneers are generally not as strong or
wear-resistant as porcelain veneers, composite
veneers can be repaired easily and quickly

Steps to place composite resin veneers:

After the teeth are prepared or reshaped, the

dentist carefully bonds and sculpts the composite
material using a color that is best for you.

A special light is used to harden the composite and

bond it to your teeth.

The veneers are smoothed and polished to look like

natural teeth.

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 By:
Dr.Hussam Albarraq

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