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International Journal of Dental Health Concerns (2015), 1, 1-5
Porcelain veneers are increasing in present esthetic dental
treatment because it is one of the conservative restorations of
unaesthetic anterior teeth. Although this technique was rst
described in 1940 by Dr. Charles Pincus, developments in
composite resin technology and acid etching of enamel and
ceramic were required for it to become widely recognized.[1-3]
Unfortunately, composite resins shows polymerization shrinkage,
thermal dimensional changes, staining and poor wear resistance
and used as veneers, have limited life of 4 years or less. The
acrylic laminates veneer was an attempt to overcome some of the
problems, but the long-term results were clinically unacceptable.
Recent clinical studies have shown very good long-term result
following the placement of anterior porcelain veneer. In one 5-year
study, 83% were satisfactory, while in 8-year study, 95-97% were
successful. However, the placement of porcelain is an irreversible
procedure because of necessity for tooth preparation. Therefore,
the criteria for porcelain veneer must be carefully reviewed before
the procedure is undertaken for its long term success.
The purpose of this article is to review the current literature
and to present the important parameters such as inclusion and
exclusion criteria, shade selection, tooth preparation, veneer
placement (cementation), patient maintenance for determining
long-term success of porcelain veneers.
The literature source of present paper are published articles,
internet sources, manuals, and textbooks reference in relevant
papers and peer review articles, involving porcelain veneer by
reviewers. The search terms used were broad so as to ensure
the relevant studies were not missed, the search terms used
were, porcelain veneers, veneers in dentistry, Esthetics, enamel
bonding. Academic colleagues were also contacted to identify
relevant research. The search duration was for 3 months
between October 2014 and December 2014. Total of 150
articles were identied through search strategy, and 22 articles
met the inclusion criteria and they were included in the review.
The inclusion criterion were, articles which were in English
language, full-text articles, articles with online accessibility,
both review and case studies related to porcelain veneers.
Articles with only abstracts and incomplete information
and articles with veneers used for non-dental reasons were
The rst important parameter for long term success of porcelain
veneer is case selection.[4] The prime requirements in case
1Department of Prosthodontics, Jagadguru
Sri Shivarathreeswara Dental College and
Hospital, A Constituent College of Jagadguru
Sri Shivarathreeswara University, Mysore,
Karnataka, India.
2Department of Public Health Dentistry,
Jagadguru Sri Shivarathreeswara Dental
College and Hospital, A Constituent College
of Jagadguru Sri Shivarathreeswara University,
Mysore, Karnataka, India.
Correspondence: Dr. S. Sowmya, 332/1,
Near Kamakshi Hospital, Kuvempu Nagar,
Mysore - 570 023, Karnataka, India. Mobile:
+91-9886214888, Email: Sowmya.neelan@
How to Cite:
Sowmya S, Sunitha S, Dhakshaini MR,
Raghavendraswamy KN. Esthetics with veneers:
A review. Int J Dent Health Concern 2015;1:1-5.
Received: 15.01.2015
Accepted: 22.03.2015
Veneer is one of the most revolutionary techniques developed over the past 25 years.
When dental professionals realized that porcelain can bond onto the composite and
therefore onto the tooth surface, it changed everyone’s view. An attractive appearance
with veneer has shown to increase people’s self-condence, personal relationship, and
even the success in his or her career. Hence with veneer, it is possible to create amazing
esthetic results and yet retain considerable solid tooth structure. Successful result
depends not only on the clinical and laboratory technique used for veneer fabrication,
but also on an understanding of scientic background of the procedure involved since
the placement of porcelain is an irreversible procedure it requires conservative tooth
preparation. Therefore, the criteria for porcelain veneer must be carefully reviewed before
the procedure is undertaken for its long term success. The purpose of this article is to
present the most important parameters such as inclusion and exclusion criteria, shade
selection, tooth preparation, veneer placement(cementation), patient maintenance for
determining long-term success of porcelain veneers.
Key words: Enamel bonding, esthetics, porcelain veneer
Esthetics with Veneers: A Review
S. Sowmya1, S. Sunitha2, M. R. Dhakshaini1, K. N. Raghavendraswamy1
Doi: 10.15713/ins.ijdhc.11
Esthetics with Veneers… Sowmya, et al. I J D H C
selection are a high standard of oral hygiene and health and
presence of an adequate area of sound enamel available for
etching. Among the main reasons for placing veneer are:
correction of unaesthetic surface defects such as hypoplastic
enamel or enamel lost by erosion[5,6] or abrasion
masking of discoloration resulting from trauma
endodontic treatment
tetracycline stains
repair of structural deciencies such as fractured incisal
edge,[4] diastema[7] and peg laterals.
A decreased success[8] is seen when porcelain veneer is restored
in teeth:
With inadequate enamel and tooth structure such as
amelogenesis and dentinogensis imperfecta
When there is existing large restoration or root canal treated
teeth with less tooth structure
Patient with oral habit[9] causing excessive stress on
restoration and excessive interdental spacing.
The next important clinical parameter for the long term success
of porcelain veneer is shade selection procedure. Proper shade
selection is not only with matching the shade using shade guide,
but involves various technique with proper lighting.[10] Some of
the tips for shade selections are:
Shade matching must be carried out in early hours of
appointment to avoid color fatigue
If patient is wearing bright color clothing, drape in Neutral
colored cover, have patient remove lipstick and other
Clean the teeth and remove all stains and debris
Have patient’s mouth at dentist’s eye level
Shade comparisons should be performed at 5 s interval so as
to not to fatigue eyes
Use canine as reference
Grind o the neck of the shade tabs because it is darker than
rest of tab
If there is confusion between two shades then it is always
better to select a shade of lower chroma and higher
Before starting preparation and after establishing the desired
shade the preexisting restoration and defect should be corrected
and the anomalies contoured.[8]
Why We Need Preparation?
Shaini et al. reported that 90% of the restorations placed in their
patients were on unprepared teeth and concluded that this could
have been responsible for low success rate in their study.[11]
Hence, preparation is needed mainly to
Get denite nish line
Provide space
Get uoride-rich layer
Rough surface for better retention.
Today most authors agree on the importance of tooth preparation
to achieve long term success. Conservative intra enamel preparation
with facial reduction of enamel by 0.3-0.5 mm and nish line
placed at or close to the gingival margin are recommended. Tooth
preparation should not include any sharp internal angle, especially
at the incisal edge where the stress will be greatest, it should allow
for a path of insertion of the veneer which is free from undercuts.
Sequence of Tooth Preparation
Labial surface reduction
In-vitro tooth preparation analysis has shown that the cervical
portion is usually over prepared with dentin being exposed and
the mid-incisal portion is usually underprepared. This nding
conrms that careful depth control is necessary. Many dierent
designs of depth -control cutting diamond are marketed
exclusively for veneer preparation. The key to the success is the
placement of the cutting instrument in two to three dierent
planes along the convex labial surface. Three horizontal surface
depth cuts are prepared on the labial surface with three tiered
depth cutting diamond [Figures 1 and 2]. Using the depth cuts
as guide, labial surface is prepared to prevent over reduction
(0.3-0.5 mm). Pencil lines can be marked into the enamel guide
grooves [Figures 3 and 4]. For the standard preparation, chamfer
is placed at the height of gingival crest unless severe discoloration
mandates a subgingival margin to gain extra veneer thickness.
More success rate was seen with supragingival nish line because
Increases the area of enamel
Moisture control is better
Visual conrmation is excellent
Accessibility is good
Maintenance of hygiene is better.
The preparation will be extended lingually only if diastema or
peg lateral incisor has to be restored.[10] As much as possible the
contact area should be preserved because its
Esthetics with Veneers… Sowmya, et al. I J D H C
Extremely dicult to reproduce
Simplies the try-in
Bonding is easy
Saves clinical time and
Provides better access.
There is no consensus on whether the incisal edge of the tooth
should be included in preparation for porcelain veneers.[11] In the
opinion of some authors incisal coverage in necessary in all cases
to enhance the mechanical resistance of veneer, even though this
involve the removal of 0.5-2.0 mm of intact incisal edge and may
place the vulnerable cavosurface margin in an area of opposing
tooth contact.[11] Other authors have suggested incorporating the
incisal edge into the preparation only when dictated by esthetic
or occlusal requirement.[12]
Hui et al. concluded from an in vitro study that porcelain
veneer fabricated to three dierent design, demonstrated that
the window type of preparation was strongest compared with an
overlapping and feathered design.[13]
Gingival retraction is usually needed for maxillary teeth and dark
teeth. Apical inltration over the teeth with the local anesthetic
solution is also advised. However, care must be taken to prevent
a subsequent gingival recession. A single cord is used which
remains in place when impression is being made and no extra
hemostatic agent in the cord is needed because bleeding should
be minimal with healthy gingivae.
Impression technique: Any recognized elastomeric impression
material is suitable for recording the preparation. If the preparation
is limited to maxillary anterior teeth, an anterior stock tray is
adequate. However, an alginate impression is suggested prior to
preparation so that the custom tray is fabricated. A special tray
is extended 5 mm gingival from gingival margin and cover half
of palatal surface, adjacent unprepared teeth, and occlusal stop.
When lower anterior teeth are prepared, it is necessary to have a
custom tray of entire mandibular arch.[11,14]
Figure 1: Three tiered depth cutting diamond bur
Figure 2: Three horizontal surface depth cuts with pencil lines marked
Figure 3: Labial reduction
Figure 4: Complete labial reduction
Esthetics with Veneers… Sowmya, et al. I J D H C
Patients seldom experience sensitivity as a result of the
preparation of enamel and are usually not unhappy about the
appearance, in which case temporary cover may be omitted. But,
if temporary restoration is needed then the materials used are
preformed acrylic resin veneer and composite resin. Temporary
veneer under functional stress may be “spot welded” for better
Today four groups of ceramics are used for veneer: Feldspathic
porcelain, cast or pressed porcelain, heat-pressed and CAD-
CAM. Porcelain made of baked feldspathic porcelain allow a
minimal veneer thickness of 0.3 mm which means that the amount
of tooth substance that has to be removed for preparation can be
kept to a minimum. However, feldspathic porcelain are brittle,
and the sintering of porcelain particles creates microporosites
which results in low exural strength. Castable glass-ceramics
and heat - pressed leucite reinforced ceramic oer greater exural
strength when the veneer thickness is not <0.5 mm. Therefore,
the preparation must be 0.6-0.8 mm thick which conict with the
conservative nature of the restoration.[11,12]
The veneers are fragile and should be handled with care,
preferably with the nger and over a color constrating surface
such as a dark paper napkin. Inspect veneer for any crack and
imperfection on the model for appropriate t, then remove
provisional with a hemostat, break the brittle composite used
for luting the temporary restoration, and pumice all areas of
prepared surface.[15] Moisten the teeth and internal surface of
porcelain with water and place on teeth and evaluate t and
color. Adjustment are made with ne diamond bur and veried.
Special eect such as check lines, white hypoplastic patches
and translucent incisal edges are normally incorporated into the
porcelain during build up in laboratory, but some slight staining
modication may be made at the chairside, as further ring of
porcelain is not possible. There are a number of staining kits,
mainly in the form of lightly lled resins, which include coloring.
There are 3 basic ways of attaching porcelain laminates to the
surface of teeth.
Chemical attachment: Cements (light activated composite
and coupling agent)
Micromechanical attachment: Acid etching
Combined attachments.
Recently, Dune and Millar reported that the clinical longevity
of ceramic veneer is more related to marginal adaptation.[16,17]
Hence, cementation(bond between tooth and porcelain) is one
of the most important parameter for success.[18]
Procedure: The teeth are isolated with cotton, lightly
repolished, and washed. The selected tooth is separated from its
neighbors with mylar strips, etched for 60 s, washed, and dried.
Light-cure bonding agent is applied to etched enamel and excess
blown o. The selected shade of cement is placed evenly on the
porcelain to cover the whole tting surface without trapping air.
A 10 s spot cure of the cement labio-incisaly, after the veneer
has properly positioned, permits removal of the unset excess
elsewhere before nal curing.
On completion of placement excess cured cement is removed
with ne, water-cooled diamond and interproximal clearances
conrmed with ne separating strips.
Excessive stress on newly placed veneer should be avoided as
it takes 24 h for the coupling agent to develop its maximum bond
strength. Final polishing is much better delayed to later visit.
Materdomini has reported that porcelain veneer esthetics can
be enhanced with the contact lens eect concept.[19] Concept:
When the veneer is cemented to tooth structure, it blends
optically with the substrate, becoming dicult to detect. To
achieve this eect; two elements must be controlled. The rst:
Translucency/opacity of porcelain veneer itself. The second,
translucency/opacity of luting composite. If either element
results in high opacity level, especially at the margin, the contact
lens eect will not be achieved.
The teeth should be professionally cleaned 3-4 times yearly.
Hygienist should be warned not to use ultrasonic scaling or air
abrasive. These procedures will prolong the life of veneers.[20]
The survival probability of porcelain veneers according to the
Kaplan - Meier survival estimation method was 97% at 5 years
and 91% at 10½ years.[21,22]
The failure rate signicantly increased when the nish line
crossed an existing lling, while no inuence was found for
the type of preparation of incisal edge, the location of gingival
preparation margin, or the amount of time the veneer was in use.
In another study done in 2012, it was found that the survival
rate to be 94.4% at 5 years, 93.5% at 10 years and 82.93% at
20 years. The maximum number of failures found by these
authors was a ceramic fracture. People with parafunctional habit
especially bruxisum and discoloration at the margins in smokers
showed more failures. Yet another study reported 97.5% survival
rate at 7 years.
Esthetics with Veneers… Sowmya, et al. I J D H C
The porcelain veneer is very esthetic and conservative treatment
option for many indications. The success of porcelain veneer
depends very much on the method of fabrication and most
importantly case selection. The research in this eld has been
based on personal preference and anecdotal information, more
objective research is required so that porcelain veneer will
become better successful.
1. Buonocore MG. A simple method of increasing the adhesion
of acrylic lling materials to enamel surfaces. J Dent Res
2. Calamia JR. Etched porcelain facial veneers: A new treatment
modality based on scientic and clinical evidence. N Y J
Dent 1983;53:255-9.
3. Horn HR. Porcelain laminate veneers bonded to etched
enamel. Dent Clin North Am 1983;27:671-84.
4. Lim CC. Case selection for porcelain veneers. Quintessence
Int 1995;26:311-5.
5. Ried JS, Simpson MS, Taylor GS. Using porcelain veneer to
treat eroded teeth. Dent Abstr 1991;36:225-56.
6. Walls AW. The use of adhesively retained all-porcelain
veneers during the management of fractured and worn
anterior teeth: Part 1. Clinical technique. Br Dent J
7. Hunt NP. Hypodontia – Problems of permanent space
closure. Br J Orthod 1985;12:149-52.
8. Malone WF, Tylman SD, Koth DL. Tylman’s Theory and
Practice of Fixed Prosthodontics. 8th ed. St Louis: Ishiyaku
Euro-America; 1989.
9. Heyde JB, Cammarato VT Jr. A restorative system for the
repair of defects in anterior teeth. The laminate veneers.
Dent Clin North Am 1981;25:337-45.
10. Shillingburg HT, Hobo S, Whitsett LD, Jacobi R,
Brackett SE. Fundamental of Fixed Prosthodontics. 3rd ed.
Chicago: Quintessence Publishing Co, Inc.; 1997.
11. Dumfahrt H. Porcelain laminate veneers. A retrospective
evaluation after 1 to 10 years of service: Part I – Clinical
procedure. Int J Prosthodont 1999;12:505-13.
12. Highton R, Caputo AA, Mátyás J. A photoelastic study of
stresses on porcelain laminate preparations. J Prosthet Dent
13. Hui KK, Williams B, Davis EH, Holt RD. A comparative
assessment of the strengths of porcelain veneers for incisor
teeth dependent on their design characteristics. Br Dent J
14. McIntyre FM. Placement of retraction cord during porcelain
laminate (veneer) restorative procedures. J Prosthet Dent
15. Clyde JS, Gilmour A. Porcelain veneers: A preliminary
review. Br Dent J 1988;164:9-14.
16. Dunne SM, Millar BJ. A longitudinal study of the
clinical performance of porcelain veneers. Br Dent J
17. Fuzzi M, Bouillaguet S, Holz J. Improved marginal
adaptation of ceramic veneers: A new technique. J Esthet
Dent 1996;8:84-91.
18. Swift B, Walls AW, McCabe JF. Porcelain veneers: The eects
of contaminants and cleaning regimens on the bond strength
of porcelain to composite. Br Dent J 1995;179:203-8.
19. Materdomini D, Friedman MJ. The contact lens eect:
Enhancing porcelain veneer esthetics. J Esthet Dent
20. Goldstein RE. Change Your Smile. 3rd ed. Indian edition.
Chicago: Quintessence Book; 1997.
21. Dumfahrt H, Schäer H. Porcelain laminate veneers.
A retrospective evaluation after 1 to 10 years of service:
Part II – Clinical results. Int J Prosthodont 2000;13:9-18.
22. Strassler HE, Weiner S. Seven to ten year clinical evaluation
of etched porcelain veneer. J Dent Res 1995;74:176.
... 2 Porcelain veneers is a thin bonded ceramic restoration that restores the facial surface and part of the proximal surfaces of teeth requiring esthetic restoration. 3,4 The indications of dental veneers include 1) discoloured teeth due to many factors such as tetracycline staining, fluorosis, amelogenesis imperfect, age and others 2) restoring fractured and worn teeth, 3) abnormal tooth morphology, 4) correction of minor malposition 5) Intra-oral repair of fractured crown and bridge facings. Unfavourable conditions of dental veneers include 1) patients with parafunctional habits such as bruxism 2) edge to edge relation, 3) poor oral hygiene, and 4) insufficient enamel. ...
... Unfavourable conditions of dental veneers include 1) patients with parafunctional habits such as bruxism 2) edge to edge relation, 3) poor oral hygiene, and 4) insufficient enamel. [4][5][6] The concept of no preparation or minimalpreparation has followed the development of appropriate enamel bonding procedures. The colour and integrity of dental tissue substrates to which veneers will be bonded are important for clinical success using additional veneers with a thickness between 0.3 mm and 0.5 mm, 95-100% of enamel volume remains after preparation and no dentin is exposed. ...
... The colour and integrity of dental tissue substrates to which veneers will be bonded are important for clinical success using additional veneers with a thickness between 0.3 mm and 0.5 mm, 95-100% of enamel volume remains after preparation and no dentin is exposed. 3,4 According to multiple clinical studies, porcelain veneers have excellent aesthetic results, the longevity of the treatment and patient's satisfaction. 4,5 Many studies investigated the longevity of porcelain veneers. ...
Full-text available
The increasing demand by patients for esthetic and metal-free restorations has driven the development of ceramic restorations with good esthetic and mechanical stability. The use of porcelain laminates veneers to solve aesthetic and or functional problems has been shown to be a valid management option especially in the anterior aesthetic zone. The current porcelain veneers are esthetically superior, conservative and durable treatment modality. The present case report describes the treatment of discoloured tetracycline teeth in the anterior dentition with thin porcelain laminate veneers and Yttrium-oxide partially stabilized zirconia (YTZP) bridge for missing upper right lateral incisor tooth and treated for problem. The restorations were evaluated clinically over for retention, colour match, surface texture, marginal integrity and gingival response. The patient was very satisfied with the result and had no complaints during 1.5 years of follow-up.
... This in turn improves the selfesteem, condence thus boosting the social life of the patient. They were rst used in 1928 by a California dentist Charles Pincus for changing the appearance of an actors teeth temporarily for a lm [2] shooting. Since then there has been a great demand for veneers as an effective esthetic alternative. ...
... Veneers are manufactured from various materials like ceramic, porcelain, composite resin, micro-lled composite resin, preformed [2] acrylic laminates, glass-ceramic veneers etc. Ÿ Long-lasting restorations due to enamel bonding. Ÿ High patient acceptance. ...
Veneers have made a breakthrough in dentistry in recent times. They have been predicted to increase a patient's selfcondence, personal relationship, and even success in his or her career. Hence, with veneers, it is possible to create amazing esthetic results and yet retain a considerable amount of tooth structure. Successful results depend not only on the clinical and laboratory technique used for the assembly of veneers but also on an understanding of the scientic background behind its material aspect and case selection. Veneers have evolved in the past 10 years or so in the material aspect. Various materials are used to fabricate veneers like composite, processed composite, porcelain, ceramic, preformed acrylic laminates, and glass-ceramic veneers. The current article is a review that illustrates recent advancements in the material aspect of dental veneers.
... Además, de acuerdo al resultado por ítems individuales, en esta investigación el 43.9% de la población reconoce que se requiere de la eliminación de tejido dental para el uso de carillas dentales; mientras que, en el estudio de Alghamdi D. et al. 1 se obtuvo un resultado de 73.2%; sin embargo, en la investigación de Ramos A. et al. 19 realizada en Perú, se evidencia un resultado similar al de esta investigación, con un porcentaje de 53.46%. En este sentido, es preciso recalcar que si bien es cierto existen diferentes protocolos actuales para los tratamientos con carillas dentales que están orientadas a la mínima eliminación de tejido dental, 7 no deja de ser necesaria la eliminación mediante el desgaste adamantino y, en muchos casos dentinario, 22 cuestión que debería ser de conocimiento de los pacientes. Además, enfatizar que, aunque esta investigación aborda un tema relacionado a un tratamiento estético, los resultados obtenidos apuntan a un conocimiento de nivel medio; esto podría llevar a una reflexión: en el Perú el acceso a la información correcta sobre tratamientos estéticos dentales es limitada, lo mismo sucede con la información básica sobre tratamientos odontológicos preventivos, que no es difundida oportunamente a la población. ...
... Shade selection has to be done in a systematic protocol which follows as,Operating site lighting (shade selection day light), environment (no bright surrounding environment), tooth condition (no stains and deposits) and using a Vita Classical Shade Guidebased on the hue 26 . Studies have shown that incorrect technique used in matching the shade greatly impacts the final restoration outcome 27,28 . Great emphasis has been placed on the environment of the shade selection, which leads to alteration of shade if not taken properly in daylight. ...
Full-text available
Aim: To assess the aesthetic satisfaction with the metal-ceramic dental prosthesis in relation to patient education, age and gender. Methods: This prospective longitudinal study was undertaken by selecting 360 adult patients from both genders indicated for single maxillary porcelain fused to metal crowns. These patients were categorized into three groups based on gender, age, and education. Patients were assessed for aesthetic satisfaction for tooth shape; color, angulation, visibility, and shade at the time of insertion and at a follow-up of 12 weeks. At the time of the prosthesis insertion, a self-evaluation questionnaire was provided to each patient to record their satisfaction levels with the prosthesis. Satisfaction levels among the participants were evaluated based on participants' age, gender, and education level (Chi-square). A p-value of 0.05 was considered statistically significant. Results: The study enrolled 150(41.67%) males and 210(58.33%) females with the participant age ranging from 19 to 60 years and a mean age of 30.53 (± 10.88 years). 84(23.3%) were uneducated participants, 210(58.3%) were high school graduates, and 66(18.3%) were university graduates. A decrease in the level of satisfaction was observed with increasing years of patient education at insertion. The overall aesthetic satisfaction among patients at PFM crown insertion (65%) and at 12 weeks follow-up (69.2%) was statistically comparable (p>0.05). Practical implication: Aesthetic is the most important consideration for the replacement of anterior teeth. Numerous studies evaluated the aesthetic satisfaction of the patients after providing full ceramic prosthesis, however, data regarding patient satisfaction after the metal ceramic dental prosthesisis scarce in the scientific literature. Conclusion: Satisfaction with the esthetic restoration depends on patient education and awareness. Age and education add to a person's experience and increase awareness with respect to better aesthetics.
... Among the main reasons for placing veneer arecorrection of unaesthetic surface defects such as hypoplastic enamel or enamel lost by erosion [6,7] or abrasion masking of discoloration resulting from trauma endodontic treatment tetracycline stains repair of structural deficiencies such as fractured incisaledge, diastema and peg laterals. [8] Ceramic veneers are not preferred in teeth with inadequate enamel and tooth structure such asAmelogenesis and Dentinogensis Imperfecta, when there is existing large restoration or root canal treated teeth with less tooth structure ,Patient with oral habitcausing excessive stress on restoration and excessive interdental spacing. [4] Ceramic veneers are minimally invasive, aesthetically pleasing , durable, have ability to elicit a good tissue response but are technique-sensitive and time-consuming to place Repair can be difficult, More than one visit is require at the same time [4]. ...
Full-text available
Laminate veneers are restorations which are envisioned to correct existing abnormalities, aesthetic deficiencies and discolorations. They are of two types direct and indirect laminate veneers. In this case report, indirect ceramic laminate veneer technique used for patient with aesthetic problems related to discolorations old prolapsed restoration, is described with six months follow up. Patient was satisfied with the new smile. As a conclusion, indirect laminate veneer restorations may be a treatment option for patients with the aesthetic problems of anterior teeth in cases similar to the one reported here.
... Dental veneer is a thin layer of material usually porcelain or composites that cover the labial surface of the tooth [28]. They are the least invasive indirect restoration especially for anterior teeth. ...
... With increasing demand for maximum esthetics, the use of ceramic restorations is an important part of dentistry, and the use of these restorations is increasing due to maximum esthetics and lack of metal in their structure (1)(2)(3). Porcelain laminate veneers (PLVs) are among these restorations that provide optimal esthetics for patients (4). In the construction of PLVs, glass ceramics such as feldspathic and e-max press are more commonly used. ...
Full-text available
Background and Aim: The conventional procedure for removal of porcelain laminate veneers (PLVs) is time-consuming and inconvenient. The purpose of this study was to evaluate the efficacy of Er:YAG laser for debonding of PLVs. Materials and Methods: Forty-eight intact extracted human maxillary anterior teeth received discoid PLVs (24 feldspathic and 24 e-max ceramic). The PLVs had 0.7 mm thickness and 4 mm diameter. After cementation of all PLVs with a light-cure cement, samples were stored at 37ºC distilled water for 48 h. Samples of each ceramic were randomly divided into 3 groups of 8 samples. Then, laser was irra-diated on the cemented PLVs as follows: (I) feldspathic PLVs without laser irradiation (control group), (II) feldspathic PLVs with laser irradiation (6 s, 10 Hz, 200 mJ, 2 W), (III) feldspathic PLVs with laser irradiation (6 s, 10 Hz, 300 mJ, 3 W), (IV) e-max PLVs without laser irradiation (control group), (V) e-max PLVs with laser radiation (6 s, 10 Hz, 200 mJ, 2 W), (VI) e-max PLVs with laser irradiation (6 s, 10 Hz, 300 mJ, 3 W). The shear bond strength of all samples was measured using a universal testing machine. We used Mann-Whitney and Kruskal-Wallis tests for data analysis (P<0.05). Results: Laser irradiation decreased the shear bond strength of both ceramics. But this decrease was only significant for the e-max group (P<0.05). No significant difference was found between different laser irradiation powers in the two ceramic groups. Conclusion: Er: YAG laser is effective for debonding of e-max PLVs.
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ARTICLE INFO ABSTRACT Currently there is a great search for aesthetics in all areas, be it physical or social behavioral. In this way, there was a valorization and a growing demand for Aesthetic Dentistry, which works in an integrated way with other specialties and professionals to transform smiles, returning function, modifying colors, formats, leaving an appearance even more suited to beauty standards. There are several restorative options to establish an aesthetic and harmonic smile that is in the standards of demand and expectation of patients. The porcelain laminates veneers stand out in the current dentistry because they combine high aesthetic appeal and patient satisfaction with the preparation of increasingly less invasive teeth. This concept has been in existence for more than 25 years, and a classification system has been proposed for the types of preparation designs in the dental structure, which benefits both the dentist and the patient, as it assists in multiple aspects of treatment planning and communication. This literature review aims to evaluate the influence of the types of preparation designs most discussed in the literature for porcelain laminates veneers. With this it was possible to conclude that there exist that: the preparation of window type has a lower microleakage index than the other types; The preparation with reduction in the proximal ones has advantage in eliminating the risks of formation of pigmentations along the proximal margins; The feather-type preparation has the advantage of conserving the enamel and maintains the orientation on the natural tooth; Bevel type preparation (with incisal reduction) has the advantage of returning aesthetic and functional characteristics, as it allows the ceramic technician to form an incisal translucency, guaranteeing excellent optical properties in this region; And, finally, the Overlap preparation with Palatine Overgrowth, demonstrates a higher resistance than the other types of preparation, although it tends to present a higher risk of microleakage in the palatal margin. However, in relation to clinical longevity, there were no statistically significant differences between the types of preparation.
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An in vitro study, using dynamic stress analysis and two dimensional photo-elasticity, carried out to relate the strength of porcelain veneers fabricated to three different designs, demonstrated that the 'window' type of preparation was the strongest compared with 'overlapped' and 'feathered' designs. It also confirmed that the strength of the veneer was not proportional to its thickness. It can be concluded that where strength is an important prerequisite, the most conservative type of veneer, namely the 'window' preparation, is the design of choice.
A case is described, illustrating several of the problems which can be encountered in the management of this group of patients.