Jun 29, 2013

Dental Veneers

I know it's  been a long time since my last post. But here I am enjoying of my first day of vacation. A long time ago I did a rotation program at school, we had to do some laboratory work for the teacher. What I did is:
1. I did a copy of a dental cast
2. I destroyed some teeth 
3. I build it up with green wax 





After recontructing the teeth, the teacher ask me to make a copy of that and prepare the case for veneers. 
At first I took a look on internet and I concluded some ideas of veneers. 

It is thin slices of porcelain that cover the buccal of the anterior teeth.
Other names:

  • Porcelain laminate veneers
  • Porcelain veneers
  • Horn lamellae


The discoverers were:

  • Buonocuore 50s
  • Rochette 60s
  • Bowen and Simonsen 80s


Materials:

  • Conventional feldspathic porcelain (ideal, more aesthetic)
  • Leucite-injecte reinforced feldspathic porcelain 
    • More rigid
    • Empress (representative system)
  • Aluminous Porcelain processed by computer.
    • CEVEC, Celay, procera.
    • More resistant and opaque
    • Not as much adhesion as feldspathic
  • Polymers or resins
Indications:
  • Color anomalies
    • Amelogenesis (Although isn't the most indicated)
    • tetracyclines
    • Fluorosis
    • stains
  • Form alterations
    • Microdontia
    • Convert the canine into lateral incisor (agenesis)
  • Abnormal structure or texture
    • Dysplasia
    • Abrasions
    • Coronary fractures 
  • Malpositions
    • Rotations
    • abnormal angulatio
  • Diastemas
It isn't indicated in this cases:
  • Inadequate Enamel (minimum 50%)
  • Margins outside of the enamel
  • devitalized teeth
  • Small clinical crown
  • Teeth with cavities or fillings
  • Poor oral hygiene
  • Erupting teeth
  • Fractures involving more than 2/3 coronal
  • Severe stains or bad habits such as:
    • bruxism 
    • onychophagia
  • Inadequate Occlusion 
  • Important Malposition 
Once we have all the necessary information, we can explain to the patient if he wants the veneers. First of all we have to do a diagnostic wax. It is like important to prepare the case. Here we have the cast copy. 



1) 3 Buccal horizontal guide grooves 0.3-0.4mm
the the TFC1 Touatti guide, TFC2 drills.


2) Vestibular reduction 
We mark with pencil to reduce not longer than desired.
Respecting the 2 planes with cylindrical cutter.
Average reduction of 0.5mm (0.7-0.8mm 0.6-0.7mm incisal and medial)
0.3mm Margin  chamfer
Reaching invisible areas without touching contact points





Final work: