Technological Breakthroughs:

Learning How Porcelain Laminate Veneers are Applied

 Presented by David K. Chan, D.M.D.

With the recent increase in patient’s demands for esthetic restorations in the anterior as well as posterior dentition, it has become necessary to develop new materials that combine the strength and resistance that are essential in the molar region, along with the esthetic qualities desired in the incisor region. Porcelain veneers are thin, custom made moldings that cover the fronts of unsightly teeth. They are crafted from tooth-colored, high-tech materials to portray a natural, bright smile. Porcelain laminate veneers have become the esthetic alternative to traditional porcelain-fused to metal crowns. Smiles can be transformed painlessly, conservatively and quickly with dramatic, long-lasting results with the use of porcelain veneers. Porcelain veneers are now the restorative choice for dental esthetics in numerous clinical circumstances that would have resulted in the use of full crowns in the past. Gum tissue response is excellent, and the finished surface is very similar to the natural tooth. Veneers exhibit natural fluorescence and absorb, reflect, and transmit light exactly as does natural tooth structure. Patients are highly enthusiastic about these restorations that represent a conservative treatment that enhances patient self-image.

State of the Art:

The dental profession has always been in search of restorations that have a “natural” appearance but are, at the same time, long lasting. In the past, the lack of appropriate dental materials rendered this impossible. However, advances in porcelain technology and bonding materials now offer a variety of treatments, with long-lasting restorations and improved esthetic results.

Porcelain veneers are to be considered the “state of the art” treatment in cosmetic dentistry, providing abundant advantages over previous forms of esthetic treatment.

Strength:

Owing to their ceramic thinness (0.3-0.5mm), the porcelain veneers can be easily fractured before they are bonded, similar to kitchen or bath tiles. However, once bonded in place, they integrate with the tooth structure and become extremely durable. Studies have shown that when a veneer is properly bonded to the tooth, it will regain the original strength equivalent to an un-restored tooth.

Enamel Replacement:

Porcelain laminate veneer restorations, bonded to the tooth with the latest generation of adhesive systems, are capable of achieving biological compatibility and function, while attaining a comparable esthetic result. All dentists agree that the natural human enamel would be the best restorative material to use if that were possible-but porcelain veneers, being the closest material to human enamel, are the least destructive to the adjoining tissues. These characteristics have established the porcelain veneers as the preferred restorative material preserving the enamel, which is ultimately the most valuable part of the tooth.

Translucency:

Since ceramic restorations allow the transmission of light in a manner similar to that of natural tooth structure, veneers offer the potential for superior esthetics.

Longevity:

The union of etched enamel and porcelain, combined with the bonding agent, enables an extremely strong bond between the veneer and the tooth. The high bond strength between the veneer and the tooth allows for a restoration that withstands the test of time.

The Process of Veneering Teeth in a Nutshell:

Porcelain laminate veneers start off as being very thin pieces of high-tech porcelain as shown in (fig 1). The technological miracle is the process in which this piece of porcelain is applied to the tooth where it will serve the needs of the patient functionally and esthetically for a long period of time.

The application of porcelain veneers is a two-appointment procedure, which during the first

appointment the teeth are minimally prepared, impressions taken and temporized.

The second appointment involves verification of fit, esthetics and the application of the veneers via a technique sensitive series of steps. First the veneer and the tooth are acid etched to clean and place micro-retention on the surfaces (fig 2) and (fig 3). A coupling and bonding agent is applied to the veneers and teeth respectively as shown in figure (4 and 5). The veneers are then loaded with a small amount of resin cement that can only be activated by a special light at a certain wavelength, (fig 6). The veneers are then properly fitted to the teeth and permanently bonded into place by activating the resin cement by a special curing light, figures (7), (8). The bond between the veneer and tooth as mentioned earlier is extremely strong and accounts for the longevity of the restoration. Figure (9) shows how extremely natural and beautiful a properly done veneer case can appear. The end result is a gorgeous smile the patient can appreciate for years to come!

Dr. Chan’s office “Northwest Smile Designs” specializes in cosmetic dentistry and is located in Fisher’s Landing. 19120 SE 34^th Street. Suite #104, Vancouver, WA 98683 (360)885-1206.

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