Porcelain

Veneers
 The laminate veneer is a conservative alternative to full 2
crowns for improving the appearance of an anterior or
posterior tooth

A porcelain laminate veneer is an extremely thin shell of

porcelain applied directly to the labial surface of teeth
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The veneer may be used to improve the color of

stained teeth, alter the contours of misshapen
teeth and close interproximal spaces

Tooth preparation for veneers is minimal and

remains within enamel

Porcelain veneers are bonded to enamel and

dentin with the use of etching, silane and
composite resin cement
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The thin veneer gets its strength from the ability of

the composite resin cement to bond with the
etched porcelain and etched enamel
Advantages of Veneers 5

1. Main advantage is conservative tooth preparation

typically only about 0.5 mm of facial reduction is
needed

2. Since tooth preparation is confined only in the

enamel, local anesthesia is not required

3. Superior esthetics

4. Wear and stain resistant

Disadvantages of Veneers 6

1. Difficult in producing veneers that are not

overcontoured in the gingival area

2. Cost
3. Fragility
4. Lack of repairability
5. Difficulty in color matching
Indications for Veneers
1. Stained/defective
restorations
2. Tooth fractures
3. Attrition
4. Tooth discolorations
(tetracycline stains)
5. Tooth malformations (peg
laterals)
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6. Slight tooth malpositions
7. Root exposure
8. Erosion/abrasions
9. Diastema
10. Adolescent teeth (large
pulps)
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Veneers used to close

diastema between
central incisors and lateral
incisors.
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Veneers used to cover tetracycline stains in the lower

incisors.
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Cervical abrasions covered with veneers.

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Veneers used to correct

incisal fractures and attrition.
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Use of veneers to correct malposition of maxillary anteriors

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With veneers in place from canines to central incisors

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Note the different thicknesses of the veneers to correct the

alignment of the anterior teeth
Contraindications for 18

Veneers
1. High caries index
2. Poor plaque control
3. Extensive existing restorations or endodontically
treated teeth with little remaining tooth structure
4. Bruxism/clenching
5. Short teeth
Tooth Preparation for Veneers
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Preparation should be minimal and limited to the enamel

ideally

The composite resin cement that is used for porcelain

veneers bond better to enamel compared to dentin and
cementum

The entire finish line of the preparation should ideally

remain in enamel
Labial Reduction 20

Preparation should provide a labial reduction of about

0.5 0.7 mm which follows the anatomic contour of the
tooth
For smaller teeth such as mandibular incisors, it can be
0.3 mm
 Finish line should be a slight chamfer placed in enamel at21
equigingival or slightly subgingival level (0.1 mm below
gingival margin)

Enamel provides a better seal and more effectively prevents

marginal leakage than a finish line in cementum
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Because enamel is thin in the gingival half of the labial surface
of most anterior teeth, the desired reduction in the gingival
area is only 0.3 mm
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Use of depth guide bur to ensure proper reduction in the

labial.
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Middle third
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Cervical third
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Incisal third
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To prevent overreduction, draw pencil lines into the cuts;

facial reduction is complete after the pencil lines are
removed by the bur
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Proximal Reduction for Veneer
30

A proximal chamfer finishing line is preferred and ideally

placed slightly facial to the contact areas of the
adjacent tooth
Proximal Reduction 31

The question of where to place the proximal finish line

also depends on the need to change the tooth color
with the veneer Minimal or No Color Change vs Major
Color Change

Minimal or No Color Change:

1. Diastema closure
2. Change shape, contour or size of teeth
3. Correction of malaligned or malformed teeth
Proximal Reduction 32

Major Color Change:

a. Masking discolored or stained teeth tetracycline stains,
fluorosis
Proximal Reduction 33

Minimal or No Color Change:

Proximal finish line terminates 0.2 mm facial to the contact area

Proximal Reduction 34

Major Color Change:

Proximal finish line terminates into of the labiolingual

measurement of the proximal contact
Proximal Reduction 35

Diastema closure:

Proximal areas adjacent to diastema should receive a feather

edged finish line
Incisal Reduction for Veneer 36
2 techniques: no incisal reduction and with incisal reduction
If possible, do not reduce the incisal edge; this helps support
the porcelain and prevents chipping of the porcelain
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Incisal reduction should ideally provide for 1 mm of porcelain
thickness

A butt joint finish line on the incisal provides for proper

thickness of porcelain to prevent porcelain fracture

The finish line should slope slightly gingivally (approximately 75

degrees from the facial)
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When to decide if you need incisal reduction:

a. If the tooth is thin labiolingually near the incisal, do
incisal reduction
b. If there is need for esthetic lengthening of the
tooth
c. For occlusal considerations such as fractured
incisal edge, correction of open bite, etc.
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All the prepared surfaces are rounded to prevent
areas of stress concentration in the porcelain
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A PVS guide can be used to evaluate the preparation

Impression and Provisional 42

Restorations for Veneers

Gingival retraction is usually necessary for making
impressions for veneers because the finish line is
usually equigingival or subgingival

Additional silicone or polyether impression material is

usually recommended

Since the preparation remains in enamel, most

patients do not require a provisional restoration

If you must do a provisional restoration, a light-cured

composite resin can be used to build up the tooth
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Cementation of Veneers 44

The cement of choice for porcelain veneers is the composite

resin cement because the veneers need to be bonded to the
enamel of the prepared tooth

Resin cements have superior coefficient of thermal expansion,

low water absorption and have excellent surface smoothness

They also come in different shades that can be coordinated

with the shade of the porcelain veneer
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Finished veneers on the working cast

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Trial fit of the veneers on the teeth with try-in pastes

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The inner surface of veneer is treated with

hydrofluoric acid which etches it and increases
the surface area for mechanical bonding with the
resin cement

A silane coupling agent is then applied to the

etched surface to increase the bond strength of
the porcelain to the cement

The tooth is then etched with 30% phosphoric

acid, rinsed with water and dried to achieve the
chalky white appearance of etched enamel
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Etching of enamel with phosphoric acid

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Application of bonding agent to tooth preparation

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The resin cement is loaded into the veneer and the veneer is seated into
the tooth. Resin cements are usually dual-cured (light cured and self-
cured)
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Remove the excess cement with a scaler and
interproximal abrasive separating strip

After the cement has cured, use a finishing bur

and polishing strips to polish and finish the
cement line
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