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I have illustrated a number of cases in this column where patients have chosen multiple porcelain veneers for cosmetic or esthetic improvement of their smiles. Eight, 10 or even 12 maxillary veneers can cover the entire smile zone for many patients. While multiple tooth veneers can provide for predictable results, it is not always financially possible for patients to invest at the level it takes for these types of cases. Many dentists tell me that they find the larger cases difficult to justify for patients in their general practices. These dentists, however, wish to offer veneering services for their patients and find that many patients desire them.

Direct composite resin veneers can provide a lower cost option for these patients. However, my experience tells me that porcelain veneers are the longest lasting, most durable and stain resistant option. While direct veneers can be placed with minimal or no preparation at times, indirect veneers usually require more tooth preparation to allow enough thickness of material to be fabricated on a model and be bonded to the tooth structure without fracture of the material. When increased tooth contours are desired, minimal or no preparation is possible. However, when the original tooth contour is wanted, some tooth removal is needed.

I have found ultrathin porcelain veneers to be excellent options for conservative treatment of the tooth surface. Because of the “lamination effect” of the bonding process to the natural tooth, the ceramic is strengthened just as it is when it is laminated to a metal foundation in a porcelain-fused-to-metal crown. Sometimes it takes only a few veneers to achieve the esthetic result a patient desires.

The pre-operative four maxillary incisors are shown in Figures 1 and 2. The composite was removed (Figures 3 and 4) with a 12- fluted carbide finishing bur in a highspeed handpiece without anesthesia. While orthodontic tooth movement was recommended as an option, she was not interested in that approach and wanted the immediate result achievable with a veneering process.

(1 and 2) Close-up pre-operative views. (3 and 4) Close-up views after composite was removed. (5 and 6) Close up views of minimal preparations.

 

Preparation

The four incisors were only slightly contoured using a chamfer ended diamond bur to achieve rounded angles and a subtle, but definitive chamfer margin at the height of the tissue. No incisal reduction was accomplished, but rather the preparations were gently beveled at these areas. The minimal preparations are shown in Figures 5 and 6.

 

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