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Laminate veneersLaminate veneers
( under-graduate)( under-graduate)
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A veneer is a thin covering that is bonded to thefront (visible) part of the tooth.
TYPES O L!"#$!TE %E$EE&S'
#ncisalvie
1. Direct1. Direct
ustom made laminatesustom made laminatesComposite resin materialComposite resin material
CeramicCeramic
2. Indirect2. Indirect
ustom made laminatesustom made laminatesComposite resin materialComposite resin material
Preformed stoc* laminatesPreformed stoc* laminatesComposite resin materialComposite resin materialCeramicCeramic(lumineers direct and(lumineers direct and
indirect )indirect )
AcrylicAcrylic
(($OT +SE,$OT +SE,
anmore)anmore)
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hen adding omposite resin for a direct veneer e ma'
/) +se a labial cron form.
0) !dd .&. free-hand.
Composite resin materialComposite resin materialAcrylicAcrylic
1. Temporary1. Temporary
Composite resin materialComposite resin material
CeramicCeramic
2. Permanent2. Permanent
DirectDirect
(inside the mouth)(inside the mouth)
Light-cured composite resin build up toLight-cured composite resin build up toonla the entire visible etched enamelonla the entire visible etched enamel
surface.surface.
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/) +se a labial cron form.
0) !dd .&. free-hand.
Labial cron form tried onLabial cron form tried on
toothtooth
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!dvantages Of ,irect omposite %eneers
Onl one appointment is re1uired.
The dentist directl controls color and form.
ost is reduced.
&epairable.
,isadvantages Of ,irect omposite %eneers
Time consuming.
&e1uires artistic s*ills.
E2hibit poor color stabilit and ear resistance.
hat are Lumineers porcelain veneers3
Lumineers porcelain veneers are a readmade
veneers made out of the patented porcelain erinate.
2.Indirect2.Indirect(outside the mouth)(outside the mouth)
Preformed stoc* laminatesPreformed stoc* laminates
Ceramic (lumineers)Ceramic (lumineers)
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erinate is an e2ceptionall strong tpe of porcelain
and this propert allos Lumineers veneers to be
fabricated e2tremel thin.
The thic*ness of Lumineers veneers can be as little
as 4.0 to 4.5 mm (along the same lines as a contact
lens). #n comparison traditional porcelain veneers
tpicall re1uire a minimal thic*ness of around 4.6
mm.
The cost from 7844.44 - 7//44.44 per Lumineers
veneer.
!dvantages Of Lumineers
Onl one appointment is re1uired.
E2tremel thin ( 4.0-4.5 mm)
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"anufacturer claims9 no drilling no shot protocol.
,isadvantages Of Lumineers
Poor fit beteen teeth and laminates.
+nevenl thic* cement laer.
Liabilit of over-contouring and subse1uent gum
disease and inflammation .
Tooth deca.
E2pensive.
!ccording to a statistical stud dran up b :;rich
+niversit< the failure rate of ceramic laminate veneers isnot more than 6= in 6 ears< i.e. ver similar to that of
highl popular metal-ceramics.
2.Indirect2.Indirect(outside the mouth)(outside the mouth)
ustom made laminatesustom made laminatesCeramicCeramic
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!dvantages
/. "inimall invasive treatment method. #t utili>esminimal tooth preparation mainl confined ithin enamel.
?eeping clear of the gingival margins.
0. Tissue response.
"inor degree of tissue damage during preparation or
ta*ing an impression (usuall supragingival finish
line).
@la>ed porcelain is highl biocompatible.
5. Shape< position and surface appearance can be
modified.
hange canine into lateral incisor< adAust tooth length or
transform surface te2ture permanentl and elegantl .
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B. Effective color change.
hen bleaching techni1ues becomes ineffective< laminate
veneers ma be the treatment of choice.
6. Light transmission.
#f the tooth is not stained the laminate veneer should
transmit light progressivel through its thic*ness < cement
and tooth structure giving a natural appearance .
C. ,urabilit.
eramic laminate veneers sho e2cellent biologicalation.
,ifficult to adAust the margins and the provisional
cementation is complicated.
6. ,ifficult in color matching.
Precise matching of a desired shade can be difficult
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C. Post-firing modifications.
eramics can not be re-fired once removed from its
support (not applied to the #PS Empress).
8. #nabilit to trial cement the restoration.
#t can not be retained b temporar cement for evaluation.
D. Liabilit to fracture.
Laminates are e2tremel fragile during the tr in and
cementation phase.
. Fonding procedures.
!t the bonding stage< the slightest error can mean failureation can be
completed in the laborator.
). %tchin" of tooth
58= phosphoric acid' for enamel areas (54 seconds)
and for dentin areas (/6 seconds) olloed b rinsing and dring.
#t creates micromechanical retention.
$e generation dental adhesives adhere to the
enamel and dentine simultaneousl. !ll products
should be applied to a slightl moist surface. ,ring
ithout actuall dring out is re1uired.
*. Primer on the tooth and the laminate !eneer
Spread o B-6 laers< leave for 54 seconds and dr.
The primer promotes intimate bonding beteen the
tooth< composite and ceramic.
+. ementin"
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The laminate veneer is eased into place accuratel
e2erting a stead moderate pressure. #ts held in
place b9
! special instrument ( !ccu-placer )
! a2 ball mounted on a plastic handle
! Flu-Tac* ball at the end of a large condenser.
The strips pulled off in a lingual direction.
,. Remo!al of excess cement
Frushes< scalpels (ith straight blades)< dental flossand plastic strips.
E2cess soft composite should be cleared aa before
curing.
-. #i"ht curin" for li"ht cured and dual cured
cements/
Laminates held in place b a2 or !ccu-placer orlarge condenser support< light curing .
Light curing must ta*e place from angles to ensure
complete cure.
10. Finishin"
Strips< scalpel
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Causes:
a) Inadequate porcelain thickness (insufficient reduction)
b) Inadequate retention to the tooth
c) Faulty case selection (e.g. parafunctional habits)
!. Chipping
Fracture does not e"pose tooth structure.
#mooth$ then$ polishing %ut$ &ith surface defect
$.acid etch$. silane application
and$..composite placement.
'. oor esthetics
Causes:a) Improper shade cement
b) Improper shade selection
c) Incomplete masking to the discolored tooth
d) *ercontouring (improper reduction)
+. ,ecreased marginal integrity and discolorationCauses:
a) -se of luting cement ith lo ear resistance
b) Cracks and fractures
/. Incomplete fit of the laminate
Causes0
a) Improper impression
b) -se of thick adhesi*e (consistency) making it difficult to seat thelaminate properly.
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c) resence of contaminant on the fitting surface
d) *ere"tension of the gingi*al margins
. ,ebondingCauses:
a) Inability to pro*ide dry field during cementation
b) oor manipulation of the cement
c) Inability to a*oid contamination of etched enamel (or laminate)
d) -nsteady laminate during setting of the cement
2. Caries
Causes:
a) ,efecti*e margins
b) 3icroleakage
c) oor oral hygiene
d) 4emaining caries during preparation
5. 6ypersensiti*ity
&ith e"posed dentin after preparation and not protected
7. atient discomfort
a) Improper contact (food impaction)
b) oor esthetics