How to place veneers

Author:

Tomenko Viktor Leonidovich

Date of publication:

05 августа 2024

Reading time:

5 Min

Categories:

Ceramic and composite veneers

Veneer Prosthetics: A Popular Dental Procedure

Veneer prosthetics have become one of the most sought-after procedures in modern dentistry. Veneers are thin prosthetic overlays designed to restore and enhance the appearance of teeth.

Main Functions of Veneers

Veneers not only correct the anatomical shape of the tooth but also improve its color. They can rectify external defects in the dental row and protect the enamel from various irritants.

Case Study

Consider a 30-year-old patient with increased sensitivity in the upper front incisors to cold food, drinks, and air. By placing veneers on these incisors, we were able to completely eliminate the sensitivity to irritants.

Indications and Contraindications for Veneers

Indications for Veneers:

Unsatisfactory enamel color
Chipped tooth corners
Improved tooth shape and size
Closing diastema (gaps)
Gummy smile
Non-carious lesions
Multiple restorations
Minor localized protrusion or retrusion

Contraindications:

Under 18 years of age
Bite pathology
Harmful habits
Partial or complete absence of teeth
Significant destruction of the crown part

Enamel Protection with Veneers

Besides correcting external defects, veneers effectively protect enamel from various irritants. As seen in the case of the 30-year-old patient, veneers can significantly reduce tooth sensitivity to external stimuli.

Veneer Installation Process

Scenarios for Veneer Installation

Consultation with a Dentist: During the appointment, the dentist may recommend restoring the front teeth for improved aesthetics and functionality.
Necessity of Veneers: Veneers may be part of comprehensive functional work in the oral cavity, especially for restoring chewing teeth to distribute the load properly.
Patient's Desire: Sometimes, patients request to enhance their smile aesthetics with veneers.

Preparation for Veneer Installation

Before installing veneers, professional oral hygiene and sanitation are recommended. It is crucial not to fix veneers on teeth with caries or gum inflammation, as this can lead to further destruction and rapid infection growth.

Detailed Veneer Installation Process

Installing veneers is a multi-step process requiring attention to detail at every stage to ensure the best results for the patient.

Consultation

The first step is a consultation lasting about an hour and a half. The patient is advised to arrive 10-15 minutes early to complete necessary paperwork. During this phase, the orthodontist meets the patient, listens to their complaints and wishes regarding their future smile, gathers medical history, performs an oral examination, and creates a general photo protocol. Based on the collected data, the dentist suggests possible treatment options.

Creating a Mold

After the initial consultation, the orthodontist takes impressions or scans the teeth in a 3D model to create an accurate model for further work. Sometimes a manual smile restoration on portrait photos is created for demonstration purposes.

Follow-up Consultation

In the second visit, the dentist presents the proposed smile to the patient using various methods:

Wax-Up: Wax modeling on the teeth model.
Digital Modeling: A technician virtually models the teeth and creates a 3D-printed model.
Photographic Restoration: The dentist manually restores the smile on portrait photos to show the final result.

The patient reviews the options, and if necessary, the dentist adjusts the model based on the patient's preferences.

Wax-Up Transfer to the Oral Cavity

During the consultation, the Wax-Up can be transferred directly into the mouth, creating temporary overlays without tooth preparation. This allows the patient to see the result in the mirror and evaluate the future work. Temporary constructions can be made in different shades to visualize the final result.

Determining the Color of Future Veneers

To choose the color of future veneers, a shade guide is used. The dentist offers several options, and the patient selects the most appealing shade.

Temporary Veneer Installation Process

Local Anesthesia

Before starting the procedure, local anesthesia is administered to minimize pain. In some cases, medication sedation is used to alleviate psychological discomfort during treatment.

Tooth Preparation

Minimal tooth preparation is carried out for veneer installation to preserve tooth integrity. Preparation is done using a silicone key created from the previously made model. The process involves removing no more than 0.5-0.7 mm of enamel.

Preparation can be done in one visit or divided into several stages, depending on the workload, patient's endurance, and available time. Sometimes visits are divided by jaws or segments.

Taking Impressions

After preparation, impressions or scans of the prepared teeth are taken on the same day for veneer fabrication.

Making Temporary Crowns

Temporary crowns matching the new tooth shape are made on the same day. The patient begins to get used to the new teeth, and changes in speech may occur during this period. While wearing temporary crowns, a dental technician in the lab creates permanent veneers.

Permanent Veneer Installation

Preparation and Evaluation

It usually takes one to two weeks to make the veneers. Before final installation, the orthodontist evaluates the veneers on the patient's tooth model. Only after this, the fitting process in the patient's mouth begins.

Fitting Stage

During the fitting, local anesthesia is administered if needed. The dentist checks the fit of the veneers, their quality, and if they meet the patient's expectations. If both the patient and the dentist are satisfied with the result, the fixation process begins.

Veneer Fixation Stage

Fixing one veneer takes about 15-20 minutes, so 2-3 hours are needed for one jaw. The dentist fixes the veneers, removes excess cement, and adjusts the bite. The patient returns for a follow-up visit in 2-3 weeks, and additional corrections are made if necessary. The entire process usually requires 4-5 visits.

Materials for Veneers

E-max Ceramic Veneers

Made from pressed ceramic and can be applied with or without layering. Used for both front and back teeth with a lifespan of 10 years or more.

Refractory Veneers (Feldspathic Ceramic)

These veneers are a frameless construction made from feldspathic ceramic using a refractory model.

Lumineers

Ultra-thin veneers up to 0.3 mm thick made from high-strength ceramic, produced by DenMat in the USA. Often used for natural tooth anomalies, such as peg-shaped teeth, with a lifespan of 10 years or more.

Composite Veneers

Made from composite filling material and divided into:

Aesthetic Restoration: The front part of the tooth is polished and covered with filling material to hide minor defects or lighten the enamel.
Lab-Made Overlays: Created from individual impressions. The dentist prepares the teeth, takes impressions, and veneers are made to hide minor enamel defects.

Composite veneers are often installed before orthodontic treatment or used as long-term temporary solutions.