Cosmetic Dentistry: Direct and Indirect Veneers

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  • Topic: Teeth, Veneer, Dental porcelain
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  • Published : May 17, 2013
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Cosmetic dentistry: Direct and indirect veneers
Dental veneers (sometimes called porcelain veneers or dental porcelain laminates) are wafer-thin, custom-made shells of tooth-colored materials designed to cover the front surface of teeth to improve your appearance. These shells are bonded to the front of the teeth changing their color, shape, size, or length. There are two main types of material used to fabricate a veneer, composite (resin) and dental porcelain. Porcelain veneers resist stains better than resin veneers and better mimic the light reflecting properties of natural teeth. Resin veneers are thinner and require removal of In 1930, a Californian dentist called Charles Pincus created the first veneers. These were predominantly used to improve the look and smiles of Hollywood actors and actresses at the time, many of whom it is thought, failed to take care of their teeth and appeared glamorous until the moment when they opened their mouth, only to reveal their broken or decaying teeth. It is thought that it was the procedure of adding veneers which led to the legendary ‘Hollywood Smile’. Charles Pincus pioneered dental veneers by gluing a very thin tooth like piece of porcelain over the actors natural teeth to improve the appearance and so create an illusion of perfect straight white healthy teeth, like modern porcelain veneers. The dental veneers only lasted a short while though, as they were glued on with denture adhesive. It was not until 1982, when a research by Simonsen and Calamia took place which showed that porcelain veneers could be etched with hydrofluoric acid which it was felt would enable the placement of veneers to be bonded onto the tooth permanently. Indications

Traumatized/fractured teeth
Anatomically malformed teeth
Hypoplasia of enamel
Stained/discolored teeth (intrinsic or extrinsic)
Misaligned teeth (not too much)
Eroded teeth
Or just for a better esthetic look on the patients request

Patients with bruxism
Teeth with large class 3 restorations
Severely rotated teeth(teeth that are too much rotated)
Mandibular teeth
Bulimic/Anorectic patients
Too little enamel for bonding
Patients with a bad oral hygiene
Patients with a lot of caries

The veneers are divided into three groups according to the materials and techniques that are applied: Direct, indirect and direct-indirect veneers.

The direct veneers are made of composite, directly in the dental cabinet of the clinician himself, hence the name “direct composite veneers”, meaning that the patient will leave the cabinet with the veneers already after the first meeting because no lab work of a technician is needed. It is less expensive than the ceramic veneers, but also less resistant to damage. The indirect veneers on the other hand are made in the laboratory by a technician, and are usually made in ceramics, which implies that the patient will leave the cabinet after the first meeting without the final veneers, but with temporary composite veneers, and a second meeting is required for the cementation of the final ceramic veneers. This choice is of course more expensive for the patient not only because of the ceramics, but also cause of the work that the technician is doing. There is also a small group of veneers called direct-indirect veneers, which is said to utilize the advantages of both the direct and indirect techniques of the restorations with improved physical properties, this is the least used technique that is least used.

First meeting: Preparation of the teeth, impression, color

One of the fundamental advantages of using porcelain veneers to create changes for teeth, as opposed to other types of porcelain dental restorations, is that very little tooth reduction is needed. In general (and depending upon the specifics of the case) the dentist only needs to trim the tooth the same amount as the thickness of the veneer being placed. In most cases this means that the tooth...
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