A Preparation Technique to Minimize Tooth Reduction in Porcelain Veneers
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A Preparation Technique to Minimize Tooth Reduction in Porcelai n V eneers TEXT SIZE By: Gary M. Radz, DDS 2006-07-01 The increased popularity of cosmetic dent istry and "smil e makeovers" has lead to significant increase in the number of porcelain veneers fabricated in recent years. There has also been an increased interest in minimally invasive preparations and porce lain veneers. 1-5 The use of stacked porcelain veneers allows for dentists to fabricate porcelain veneers that can be .5mm in thickness.1,4,5 Stacked porcelain veneers allow dentists to remove t he minimal amount of tooth structure needed to provide their patients with new smiles with minimal trauma to t heir natural tooth structure. .5mm of porcelain has the ability to allow the dentist alter the size , shape, color , contour , and texture of the tooth to either match the existing dentition or create a new smile to give the patient the esthetic change the are looking to achieve. It has been the challenge t o the cosmetic dentists to learn to determine how much tooth structure is required to be removed to all ow for the placement of these thin laminates of porcelain. Recently Mange and Be lser published a technique that pro vides a way for a dentist to visualize and accurately remove enough tooth structure to allow for . 5 mm of porcelain, yet provide a guideline that minimizes the chance o f over - preparation. 6 Their technique creates a wa y for dentist to see the desired end result , then work backwards in their preparation. Thus , allowing for an end result of a p reparation that does not remove . 5mm of tooth structure, but rather creates .5mm of room for the placement of . 5mm of porcelain. The following case study demonstrates the ideas published by Mange and Be lser in their textbook with some minor mod ifi cations to allow fo r practical use in private practice. CASE STUDY A 40-year -old male presented with concerns abou t the esthetic appearance of his smile. Of primary concern was the presence of multiple anterior diastemas as well as being displeased with the color of his teeth (Fig. 1). The patient was prov ided with several treatment options. To create the smile he wanted to have it was agreed to have the patient complete an in office bleaching procedure followed by placement of eight conservative stacked po rcelain veneers on #'s 5-12.
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Transcript of A Preparation Technique to Minimize Tooth Reduction in Porcelain Veneers
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A Preparation Technique to Minimize Tooth
Reduction in Porcelain Veneers
TEXT SIZE By: Gary M. Radz, DDS 2006-07-01
The increased popularity of cosmetic dentistry and "smile makeovers" has lead to significant
increase in the number of porcelain veneers fabricated in recent years. There has also been an
increased interest in minimally invasive preparations and porcelain veneers.1-5
The use of stacked porcelain veneers allows for dentists to fabricate porcelain veneers that can be
.5mm in thickness.1,4,5 Stacked porcelain veneers allow dentists to remove the minimal amount
of tooth structure needed to provide their patients with new smiles with minimal trauma to their natural tooth structure.
.5mm of porcelain has the ability to allow the dentist alter the size, shape, color , contour , andtexture of the tooth to either match the existing dentition or create a new smile to give the patient
the esthetic change the are looking to achieve.
It has been the challenge to the cosmetic dentists to learn to determine how much tooth structureis required to be removed to allow for the placement of these thin laminates of porcelain.
Recently Mange and Belser published a technique that provides a way for a dentist to visualize
and accurately remove enough tooth structure to allow for .5 mm of porcelain, yet provide aguideline that minimizes the chance of over - preparation.6
Their technique creates a way for dentist to see the desired end result, then work backwards intheir preparation. Thus, allowing for an end result of a preparation that does not remove .5mm of
tooth structure, but rather creates .5mm of room for the placement of .5mm of porcelain.
The following case study demonstrates the ideas published by Mange and Belser in their textbook with some minor modifications to allow for practical use in private practice.
CASE STUDY
A 40-year -old male presented with concerns about the esthetic appearance of his smile. Of primary concern was the presence of multiple anterior diastemas as well as being displeased with
the color of his teeth (Fig. 1).
The patient was provided with several treatment options. To create the smile he wanted to have itwas agreed to have the patient complete an in office bleaching procedure followed by placement
of eight conservative stacked porcelain veneers on #'s 5-12.
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sharp angles are smooth over. Figure 11 shows the final preparations for the stacked porcelainveneers
The final result is 8 stacked porcelain veneers (Avante, Pentron Ceramics) that are minimally
invasive and yet proved the patient with the new smile he was hoping to achieve (Fig. 12)
CONCLUSION
Stacked porcelain veneers are a wonderful, conservative way to create dramatic changes to a
patient's smile. Using the ideas demonstrated by Mange and Belser it is possible to minimize theamount of reduction of tooth structure and still be able to provide our patients with highly
esthetic results (Fig. 13).
Acknowledgements
The ceramic artistry displayed in this case was created by William "C.K." Kim, Americus Dental
Laboratory, Jamaica, New York.
Dr. Gary M. Radz maintains a cosmetically focused general practice in Denver, Colorado. He serves as an associate professor at the University of Colorado School of Dentistry. He can be
contacted at www.garyradz.com.
Oral Health welcomes this original article.
REFERENCES
1. Nash, RW, "Thin yet Strong", Dental Products Report, April 2006, pp.98-99.
2. Nash, RW, "The 'Contact Lens' Veneer", Dental Products Report, August 2005, pp. 50-52.
3. Nash, RW, "An Integrated System for Esthetics and Function", Contemporary Esthetics and
Restorative Practice, Feb. 2000, pp.18-25.
4. Rosenthal, L, Rinaldi,P, "The Aesthetic Revolution: Minimum Invasive Dentistry", Dentistry
Today, June 1998, pp.42-46.
5. Lowe, RA, "Prep for Success-The stacked- porcelain veneer preparation", Dental ProductsReport, February 2004, pp.50-52.
6. Bonded Porcelain Restorations in the Anterior Dentition - A Biomimetic Approach. Mange, P,
Belser , U., Quintessence books. Copywrite 2002. pp.200-224.
Photos
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File size: 13.7 KB (264 px X 152 px) Caption: FIGURE 5--Depth cuts are created to indicate .5mm of re...
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Caption: FIGURE 6--#9 shows .5mm of uniform facial reduction.
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File size: 13.4 KB (264 px X 146 px) Caption: FIGURE 7--1.0 mm of reduction is created at the incisal...
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File size: 15.1 KB (264 px X 162 px) Caption: FIGURE 8--.5mm of reduction on the facial and 1.0 mm of...
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File size: 15.1 KB (264 px X 163px) Caption: FIGURE 9--A sickle scaler is used to remove the remaini...
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File size: 15.2 KB (264 px X 165 px) Caption: FIGURE 10--The initial preparations upon removal of the...
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File size: 11.5 KB (235 px X 139px) Caption: FIGURE 11--The final preparations of #'s 5-12.
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File size: 12.6 KB (264 px X 144 px) Caption: FIGURE 12--The stacked porcelain veneers at the 2 day p...
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Caption: FIGURE 13--The final, conservative, esthetic result pos...
