Porcelain laminate veneers is a dental treatment that improves normally the esthetic of the patient and allow us to solve some unesthetic problems that can result after an orthodontic treatment or to improve some details that the ortho itself can’t resolve.
Initial situation. The orthodontist send us a 28 years old girl patient that wants to improve the esthetic of the anterior teeth after the aliners treatment
Right lateral view.
Left lateral view.
Patient ask us to treat only the incisors and not to touch the gingival margins as she doesn’t expose them in their smile. Then, as a regular case we need to face this diﬃcult treatments cause we need to give her esthetics with the gingival framework that we have and try to integrate four veneers in the upper arch.
For the preliminar study of the case we make a intraoral scanning to design the mock up to see if the patient likes our proposal.
Digital wax up allow us to make modiﬁcations in an easy way and if we need to copy after exactly what we design is easier for the laboratory.
Mock-up in the mouth made with Protemp 4.
Checking the color at the beginning.
After the approval from the patient, as usual, we try to make a whitening prior to make the ﬁnal work, in this case we show while we were doing only the upper arch.
The tooth preparation will be guided by the mock-up.
This allow the dentist to be more predictable on the space need for the restorative material and at same time keeps more tooth structure.
This technique allows the dentist to be more predictable on the space needed for the ceramic work without eliminating too much tooth structure.
Using the pencil to control the thickness.
Tooth are ready for the digital scanning.
Design of the veneers, 100% digital workﬂow.
Final work is ready to be cemented.
We make the try in in the patient mouth to check if everything is ok and if the patient is satisﬁed with the result.
And then we start with the luting process, isolation is mandatory.
Exposing the margin.
Checking the ﬁtting of the restoration.
Clean and ready for etching.
Applying a bit of My Custom Resin in the palatal part allow us to reduce the time of cleaning in that part after removing the rubber dam and investing less time in the excess removal.
Scothbond Universal Bonding agent is placed.
Microaspiration of the excess bonding in the gingival and interproximal area.
This minimize the bond in the areas that we don’t want to.
We apply it in the veneer and in the tooth.
After retiring all the excess we polymerize (S10).
Integration in the smile is mandatory.
And in the mouth as well.
Like natural tooth.
Close up of the anterior integration.
The orthodontic retainer of course.
100% digital work can be very eﬀective, now in the era of the cad/cam materials, fully digital protocols and simplifying procedures we can’t forget the importance of using high quality materials for the bonding stage that really allow us to be predictable and don’t have any unexpected surprises.