From the Lab | Michael DiTolla, DDS, FAGD

December 2008 | www.dentaleconomics.comxx

Mini-prep case photo essay

I have come around to no-prep veneers. As techni-cians and ceramics have improved, I have received much better results on a variety of cases; however, there are still cases in which some minimal preparation makes a big dif-ference in final esthetics. The following is such a case.

Dr. Michael DiTolla is the Director of Clinical Research and Educa-tion at Glidewell Laboratories in Newport Beach, Calif. He lectures nationwide on both restorative and cosmetic dentistry. Dr. DiTolla has several free clinical programs available online or on DVD at www.glidewell-lab.com. For more information on this article or his seminars, visit www.drditolla.com.

For more on this topic, go to www.dentaleconomics.com and search using the following key words: no-prep veneer, minimal-prep veneer, composite veneers, Dr. Michael DiTolla.

Fig. 1: A 32-year-old female patient wanted to improve her smile but did not have much luck with vital bleaching. Previously, a dentist had placed some direct com-posite veneers on the upper anterior teeth, but most had broken off or worn away.

Figs.7-8: Here are the veneers on the day of cementation. Like many patients who had stopped smiling because they didn’t feel comfortable with their smiles, this patient will have to learn to smile again. This is not just an expression. Some patients need to practice smiling in front of a mirror if they have been hiding their smiles with their hands or lips.

Fig. 2: Once you see this occlusal photo, you can determine whether this will be a no-prep or minimal-prep veneer case. I suggest that you take this type of photo or pour up a study model.

Fig. 5: I mark the areas through the matrix and reduce only in these areas.

Fig. 6: Minimal reduction

Fig. 4: I had the laboratory make a putty wash reduction guide to ensure that I would reduce the teeth only as much as needed.

Fig. 3: Based on Fig. 2, we decided that minimal reduction was needed on teeth Nos. 7, 9 and 11. A minimal-prep veneer is one that requires enamel removal for optimum esthetics but exposes no dentin.

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