Same Day Porcelain Veneers
The “Hollywood smile” is typically associated with thin ceramic works of art that are made of beautiful porcelains which very effectively emulate natural enamel and are bonded in place on front teeth.
In most dental practices, the veneering process requires that the dentist reduce small amounts of natural enamel, applies temporaries to the treated teeth, takes a mold of his/her work, and sends the mold off to a dental laboratory while the patient walks with the temporaries in place for several weeks. Then, several weeks later, the patient returns to have the dentist try in the porcelain veneers which the laboratory has fabricated, hoping that the laboratory has effectively created an esthetic situation in regards to the cosmetics and that particular patient's bite.
Sometimes, dental practices purport to provide their patients with “no-prep” veneers, whereby the patient's teeth are very minimally or even not at all prepared/ground down. Beware of the no-prep veneers. Esthetic outcomes require that they imperceptively emulate nature and do not cause problems with the gums. Natural white enamel on human teeth has a certain thickness and translucency that absorbs, bends, and refracts light to various degrees. This requires a thickness of enamel, which is typically between 1-2 millimeters thick. Porcelains need a similar thickness to esthetically emulate nature as well. The “no-prep” veneer concept sounds appealing in that less tooth structure is removed, but understand that the refractive properties cannot be accurately emulated without a corresponding porcelain thickness. Additionally, these no-prep veneers can lead to chronic gum inflammation resultant of an over contoured “emergence profile" or excessive thickness, not to mention the fact that they also require time for a laboratory to fabricate these veneers.
CAD/CAM for Same-Day Veneers in Rogers
In the past decade, digital dental techniques and procedures have evolved, which allow an adept and talented dental practitioner to fabricate and create porcelain veneers on-site, the same day, via digital CAD/CAM technology. With the CEREC® CAD/CAM chairside technology, amazingly natural and esthetic veneers can be created while the patient waits. No temporaries to fall off, no distorted molds, no laboratory mix-ups or delays, no sensitivity issues, less bacterial contamination with subsequent complications, less time away from school, family, or work; these are but a few of the advantages of this technology.
Though there are very few contraindications for this process, most in dentistry will not even consider this option due to the enormous expense, training, and skill required to provide this service, not to mention the time crunch placed upon the practitioner as the patient waits anesthetized for the end result, THAT day. And quite notably, the array of robotically millable ceramics and manual porcelains that are available for truly customized porcelain veneer chairside fabrication are mind-boggling and as good or superior to what laboratory fabricated porcelains can provide.
A final critical and often overlooked point that should be made in regards to porcelain veneer treatment involves the final bonding of the beautiful ceramic works of art. An absolutely dry field needs to be created, involving not only controlling the minuscule crevicular fluids that leach from within the periodontal/gum pocket surrounding the front teeth to be treated, but also the very humid breath of the patient and the potential weakening this contamination may have upon the final bonded result. A rubber dam, fluid control for the periodontal sulcus, and/or an Isodry® dry field vacuum isolation system, plus a high-quality composite resin bonding agent must be used to ensure a strong, esthetic, and lasting result. In summary, consideration of minimally invasive porcelain veneers should include:
- How much tooth reduction is necessary for an esthetic end result
- Whether or not temporaries are to be dealt with
- The experience and knowledge of the dental practitioner who is to provide the service
- Whether or not a dental laboratory will be utilized for veneer fabrication
- The final bonding procedure, including fluid control and quality bonding agents
- Whether or not the patient wants full input as to the final outcome-with chairside CAD/CAM, the patient watches the virtual design of the final veneer, obliterating the need to communicate with an outside lab source
Contact Dr. Nick and his team today at (479) 876-8000 and step into the future of dentistry.
***Clinical photos are original cases that were accomplished personally by Dr. Nick***