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FAQ:  Porcelain Veneers


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    Question:
    Which Veneer Product is Best? I am thinking about having my teeth done with veneers but not sure which veneer product to choose from.

    I've done a bit of research on the Internet. It seems that the best systems available at the moment include Empress Esthetics and Procera.

    I would like to have a professional view on them, in terms of esthetics (natural appearance, translucent) and durability. Price is not a concern for me. ...Visitor from NY

    Answer:
    Tthere are a number of types of Porcelain used in fabricating Porcelain Veneers and Porcelain Crowns.

    Since I cannot evaluate your teeth over the internet or determine the reasons why you are seeking Porcelain Veneers, let me review a few factors in choosing the suitable Porcelain materials.

    If you have deep staining of your teeth, along the lines of Tetracyline staining for example,then the dark colors run deep into the enamel and dentin of the tooth. In this case more tooth structure has to be prepared away to mask out the staining with the Porcelain restorations.

    One technique to hide this very dark staining is to prep out the dark tooth dentin and then bond on a thin layer of light opaque composite to cover the stained areas. After the tooth is lightened up by this technique it is much easier for the ceramic artist to achieve a beautiful shade match. He is not limited by trying to bulk the Porcelain in an effort to hide the dark tooth.

    Teeth that have rotation issues and cause the appearance of misaligned teeth are also popular candidates for veneers. These rotated structures also may require extensive preparation to accommodate a veneer that gives the appearnance of a straightened tooth (aka Instant Orthodontics).

    In the current thinking of tooth preparation for Porcelain Veneers and Crowns, there is a move towards less tooth structure getting removed to fabricate the restorations (aka low-prep, non-prep). There are some systems that promote little or no tooth removal and other systems that require much more tooth removal.

    The four basic aspects that the ceramist needs to plan for an all porcelain case is Value, Hue, Chroma and Density.

    The final shade of the ceramic veneers/crowns are a blend of the underlying color of the dentin and of the porcelain itself. So, the less the tooth is prepared, the thinner the ceramic must be, and more of an influence is made by the underlying shade of the dentin.

    One problem that arises is that a high dense shade of porcelain must be used to block out the dark tooth, which can appear too opaque to look natural. As stated previously, a hybrid composite can be used to block out dark tooth structures, thus allowing thinner ceramics.

    Although there are numerous porcelain systems and lab techniques, here are a few of the types of ceramics you may want to consider:

    Feldspathic Porcelain - A system where porcelain layers are added little by little, incorporating different shades of porcelain to create a beautiful custom color of the ceramic restorations. Davinici Veneers are created with this method.

    Porcelain Block Ingots - Another type of system where the porcelain crown or veneer is fabricated from a block of ingot of porcelain type materials. The Cerac system uses this technology, which is an in-office milling system that uses ingot blocks to create the ceramic restoration. This system is probably best used in the back regions of the mouth, as the color of the ingots is limited somewhat.

    In my practice, we consider the most critical cosmetic area in the mouth (i.e., the front smile) first. Tdhe ceramist should be free to use all his/her cosmetic skills to create my ceramics. I would want them to use as many colors, layers and custom shades as needed to provide our patient with life-like, natural looking porcelain veneers and crowns.

    I hope this information has shed some light on the subject of veneers. This is by no means a complete list of all the different porcelain systems that are available. As such you may want to continue your research on veneers to make sure you fully understand the benefits and limitations of the system you choose and the cosmetic dentist you select.

    Editorial Staff

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