porcelain laminate veneers

Integration of veneers esthetic and predictable protocols

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

Fig.1

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

Fig.2

Right lateral view.

Left lateral view

Fig.3

Left lateral view.

initial situation upper arch

Fig.4

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.

intraoral scanning design mock-up digital

Fig.5

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

Fig.6

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

Fig.7

Mock-up in the mouth made with Protemp 4.

Checking the color at the beginning

Fig.8

Checking the color at the beginning.

whitening upper arch

Fig.9

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.

tooth preparation

Fig.10

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.

tooth preparation saving much tooth structure

Fig.11

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

Fig.12

Using the pencil to control the thickness.

Tooth are ready for the digital scanning

Fig.13

Tooth are ready for the digital scanning.

Design of the veneers 100% digital workflow

Fig.14

Design of the veneers, 100% digital workflow.

Veneers ready to be cemented veneer me smileline style italiano styleitaliano

Fig.15

Final work is ready to be cemented.

making the try in the patient mouth

Fig.16

We make the try in in the patient mouth to check if everything is ok and if the patient is satisfied with the result.

isolation mandatory rubber dam

Fig.17

And then we start with the luting process, isolation is mandatory.

Exposing the margin

Fig.18

Exposing the margin.

Checking the fitting of the restoration

Fig.19

Checking the fitting of the restoration.

Perfect fitting

Fig.20

Perfect fitting.

Sandblasting with Aquacare

Fig.21

Sandblasting with Aquacare.

Clean and ready for etching

Fig.22

Clean and ready for etching.

Etching

Fig.23

Etching.

Applying my Custom Resin in the palatal part

Fig.24

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

Fig.25

Scothbond Universal Bonding agent is placed.

Microaspiration of the excess bonding in the gingival and interproximal area

Fig.26

Microaspiration of the excess bonding in the gingival and interproximal area.

This minimize the bond in the areas that we don’t want to

Fig.27

This minimize the bond in the areas that we don’t want to.

Application of a light cure cement, Translucent shade RelyX Veneer

Fig.28

Application of a light cure cement, 3M Translucent shade RelyX Veneer.

We apply it in the veneer and in the tooth

Fig.29

We apply it in the veneer and in the tooth.

After retiring all the excess we polymerize (S10)

Fig.30

After retiring all the excess we polymerize (S10).

Integration in the smile is mandatory

Fig.31

Integration in the smile is mandatory.

Integration in the mouth is mandatory

Fig.32

And in the mouth as well.

like natural tooth

Fig.33

Like natural tooth.

Close up of the anterior integration

Fig.34

Close up of the anterior integration.

The orthodontic retainer

Fig.35

The orthodontic retainer of course.

Integration of veneers esthetic and predictable protocols

Fig.36

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.