What are porcelain veneers?
Ceramic veneers, laminate veneers, or ceramic veneers are thin, multi-layered ceramic laminates that are bonded to the tooth surfaces to modify and enhance the tooth colour and shape.
This type of conservative and cosmetic treatment approach requires minimal tooth substance removal while protecting the defective fillings and discoloured teeth.
Although composite veneers are easier to make and cheaper to deliver, they could result in inferior clinical outcomes in terms of quality, strength, durability and appearance compared to porcelain veneers. Composite veneers can be discoloured or chipped over time and must be replaced more often.
What are the indications of the porcelain laminate veneers?
- Aesthetically disturbing cervical and proximal fillings and defects
- Hereditary or medication-induced tooth discolouration
- Advanced enamel hypo-mineralisation and hypoplasia
- Complex tooth trauma
- Asymmetric tooth shape and size
What are the benefits of the porcelain veneers?
- Veneer dentistry is a branch of cosmetic smile makeover dentistry which provides a brighter and whiter smile.
- Ceramic veneers have excellent surface translucence and illumination, selected in individualised shade and texture, making the appearance of dentitions healthy and natural.
- They could be ultra-thin, which requires minimal preparation and damage to healthy tooth substance.
- Dental veneers protect the unsupported cervical and proximal defects and fillings while modifying the underlying discolouration and staining to the best harmonic shade and colour.
- Compared to crowns, they require less tooth substance preparation, providing a more non-invasive treatment approach with the best aesthetically pleasing appearance.
- In case of gaps or asymmetry between the teeth, a laminate veneer can close the gaps and create a harmonically symmetrical shape and form for the teeth.
- Porcelain veneers protect broken or chipped edges
- in case of tooth size discrepancy; a laminate veneer can modify the tooth size.
- The new IPS- e.max veneers are stain-resistant and could last up to 20 Years.
What clinical preparations are required for the fabrication of the porcelain veneers?
After applying anaesthetics, we define the extent and design of the preparation according to your approved diagnostic wax-up, study casts, the morphology and anatomy of the teeth and their relationships with adjacent teeth/soft tissues & antagonist’s teeth.
Atraumatic and conservative but adequate preparation will be performed to minimise damage to the residual teeth substance. This involved only minimal removal of enamel substances. An alginate impression will be taken from the opposing jaw, and a silicone impression will be made from your prepared teeth.
A direct chair-side provisional restoration will be fabricated and cemented using temporary cement. With respect to the aesthetical and mechanical requirements, IPS E-max ceramic is selected as it offers outstanding aesthetics and shade matching, while the ceramic layering technique optimises the natural appearance and aesthetics.
The frontal and palatal views of the ceramic dental crowns fabricated by a master artist laboratory technician (Courtesy: Dr Nico Kamosi)
What are the possible risks or disadvantages involved in the provision of ceramic veneers?
Any dental treatment, including cosmetic dentistry, should be performed non-invasively or non-invasively. Tooth preparation for the dental porcelain veneers should be minimally invasive, and the cosmetic dentist should abstain from unnecessary drilling when possible. Following aggressive tooth preparation, the tooth nerve may get exposed and increase the risk for irreversible pulp damage, leading to excessive hyper-sensitivity and pain, hence the need for root canal treatment.
In superficial mild to moderate teeth staining and discolouration cases, sufficient teeth whitening should be attempted, while the results should be assessed to obtain patient satisfaction.
In simple and localised micro-trauma/ fracture or decay cases, efficient tooth bonding or composite bonding should be attempted to restore dentition in a holistic and conservative approach.
It is a common mistake to compensate for the misalignment of healthy pristine teeth by quick-solution veneer dentistry. Although the results may be a quick reward for most of the patients, the unnecessary permanent tooth substance damage is not justified! The patients and cosmetic dentists should explore and discuss the indications and the benefits of mild orthodontic treatment with non-invasive Invisalign clear aligners in such instances to avoid undue damage to healthy tooth substances.
What are the final clinical procedures for the fitting of the laminate veneers?
After the removal of the provisional restorations, the preparation surfaces will be cleaned.
The fabricated veneers will be examined for marginal adaptation and contact relationships with the adjacent and antagonist teeth. Their form, 3-dimensional proportion to the whole dentition, and aesthetic qualities will be evaluated and approved.
Once the patient’s acceptance and satisfaction are ensured, the clinical preparation will be made for the bonding of the restorations. The excess cement will be removed, and the bite will be finally adjusted.
FAQ – What do patients usually ask about composite bonding?
- Good oral hygiene
- Minimal number of fillings in those teeth supporting your veneers
- Adequate number of posterior molar teeth to reduce mechanical stress on your porcelain veneers
- No clenching or grinding habits (bruxism or para-functional activities)
- No symptoms from your jaw joints
- If you have nocturnal clenching and grinding habits or other para-functional habits, your veneer runs a higher risk of porcelain fracture.
- If you have compromised bite/chewing support as a result of posterior molar teeth, the exceeding pressure forces will cause gradual failures in the form of de-bonding, micro-fracture and eventually restorative failures.
- If you have a root canal or large fillings in those teeth supporting porcelain veneers, there is a higher risk of full crown fracture.
- If you are prone to dental decay, the long-term success of veneer therapy is compromised.
- If you have protruding teeth, they may require extra tooth preparation/removal unless they are first treated with Orthodontics.
If you have intact, healthy teeth but are concerned about your dull or discoloured teeth, we advise you NOT to pursue veneer therapy unless you have sought advice on teeth whitening (see Enlighten teeth whitening).
If you have intact, healthy teeth, we advise you NOT to pursue veneer therapy unless you have sought advice on the alignment/straightening of your crooked/misaligned teeth (see Invisalign clear aligners).
If you have small discoloured fillings, we advise you NOT to pursue veneer therapy unless you have sought advice on Cosmetic Composite bonding (see composite bonding) or in combination with teeth whitening and minor Invisalign therapy.
Dental Veneers Case Studies
See our dental veneers before and after photos from our happy patients.
Before and After Treatment
A child broken central tooth. And after a non-invasive composite restoration.
Before and After Treatment
A fractured central tooth in an adult. And after a white composite bonding.