Veneers

Porcelain Veneers

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At Dental Aesthetics Athens, we are specialized in minimally invasive veneers, that should create dramatic and natural smiles. As our core principles highlight minimal invassiveness and structural integrity of healthy teeth, ceramic veneers serve these purposes finely.

Porcelain veneers are regarded the most conservative and aesthetic dental restorations. They restore aesthetics and function even with no tooth reduction / cutting.

 

  • Aesthetic enhancement with proper shade selection
  • Matching primary and complementary colour characteristics i.e transparency, opacity, fluor- and opalesence
  • Conservative tooth preparation
  • Functional scheme of occlusion
  • Balanced occlusion to avoid catastrophic fractures
  • 360-veneers on young patients with worn teeth due to grinding or clenching

Up to recently, the only way to correct dental imperfections was to cover the tooth with a crown. However, such restorations are considered invasive nowadays. Therefore, in most cases porcelain veneers are the treatment of choice for any teeth , unless those, which bear crowns already. In our clinic, each restorative treatment is ignited with and driven by the Aesthetic Analysis and DSD (see:aesthetic analysis). The designed outcome is faithfully transferred on to the natural teeth with the use of navigation indexes soaked with flowable trial composite. So, we are able to show you how the end result may look, and that is directly from the very beginning. Limitations or contra-indications to ceramic veneers are considered pre-operatively with the Aesthetic&Functional Analysis (i.e. extreme malposition of teeth, need for periodontal therapy, need for additional treatments). Cornerstone for such conservative, yet premium aesthetic restorations is the ultra durable bonding procedures, that have been introduced the last years

Veneer is a thin layer of restorative material, which is bonded onto the front surface of teeth. Two main types of materials are utilized to fabricate a veneer, composite and dental porcelain (ceramic). Composite veneers (see: composite veneers) are either intra-orally built-up with layering technique, or extra-orally milled by CAD/CAM setup, and later bonded to teeth. As opposed to composite veneer, its porcelain counterparts can only be indirectly fabricated regularly with CAD/CAM installation. Major advantage is, that minimal preparation of the tooth (e.g. reduction) is regularly demanded. Most of the cases can be treated in ”no-cut no-drill” approach. Most veneer procedures can be carried out without anesthesia. In heavy discolorations, matching the shade of a sole veneer and blending it into the color of the adjacent teeth sometimes appears problematic, hence pre-treatment with whitening procedures of the dentition is a prerequisite. Thus, minimally invasive tooth preparation can finally be operated. Typically, a labial 0.3-0.5 mm of tooth reduction/cutting is required for a porcelain veneer. However, in well selected cases, natural tissues can be fully preserved. Especially,on retruded teeth no cutting is employed. As a result, treatment can be non-invasive and teeth can remain intact. Porcelain (ceramic) veneers are also used to resurface teeth such as to make them appear straighter and with a pleasing alignment. Porcelain veneers demand 2-3 visits.

On extreme malpositions, orthodontics should primarily be used , or orthodontics followed by veneers.

At Dental Aesthetics we use pressed ceramics e-max (IPS IVOCLAR Inc) and feldspathic porcelain.

Composite Veneers

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Composite veneers are minimally invasive restorations and broadly reputed as the direct, cost-effective, same-day technique for smile re-design.

New sophisticated composite veneers feature endurance, mechanical robustness and outstanding aesthetics. Biomimetics is their main property, as they exhibit similar optics, stiffness and elasticity with the natural teeth.

They can predictably repair shape deformities and tooth dis-colorations.

By definition, a composite veneer is a thin layer of synthetic resin, which is placed on the front surface of tooth to either improve appearance, or to comprehensively restore and mask multiple fillings.

Composite veneers can enhance brightness and correct shape of teeth so as to naturally blend with the whole dental synthesis. They harmoniously make up a mostly pleasant, healthier and younger smile.

They are easily repairable, should a fracture occur. They can be applied in ”Same-day treatment” approach Mal-positioning of teeth can be corrected with composite veneers They can precisely re-produce colour and size Composite veneers can be used for diastema closure. Small spaces of up to 1.00-1.50mm can be closed with synthetic resins. Larger diastemas should be restored with their ceramic counterparts Restoring the worn dentition. Individuals who clench or grind their teeth appear with shortened teeth resulting in a prematurely aged face. Due to their biomimetic elasticity and their color properties, synthetic resins can restore deformities in a mostly conservative approach They can provide a variety of color, shape and symmetry to facilitate complete matching with any tooth They exhibit good longevity due to fine resistance against shear and tensile forces .They can be finely polished and shined thus sustaining gloss in the long run with normal maintenance in regular re-calls Design of composite veneers is navigated by appearance and function. Therefore, the intended result is visualized initially and that is prior to teeth preparations. Limitations to the use of composite veneers can be extreme tooth-malposition, bleeding gums etc Enrichement with nano-particles optimizes brand-new resins and their optical properties to such an extent , that oftentimes rival ceramics. Therefore, synthetic resins are considered the material of choice for immediate veneers Cornerstone for such conservative, yet advanced restorations are the brand-new, state-of-the-art bonding agents exhibiting strong adhesion at the interface between tooth and restorative materials

In Dental Aesthetics we use micro-filler composites from Cosmedent Inc. USA and Asteria nano-filler composites by Tokuyama Inc. Japan.
Inlays & Onlays
Aesthetics for the Posterior Teeth
Role of Inlays & Onlays in smile makeovers
In tooth-wear cases inlays and onlays are used to increase the height of the posterior teeth on a fully non-invasive approach, thus facilitating lengthening front teeth.

Even in intact dentitions, onlays can be adhered to the posterior teeth to help provide space for longer front teeth , without compromising (eg drilling) healthy tissues.

Inlays & Onlays – Indications
When a tooth of any of these groups is excessively decayed, damaged or fractured, a direct restoration (a build-up) of conventional composite filling is often not applicable. In such cases, inlays & onlays made of porcelain or synthetic resins support the tissues successfully and with a long-term prognosis. The fabrication of those restorations provide a highly aesthetic outcome along with utmost ideal durability and strength.

The alternatives to such cases would be a crown, or root canal therapy and a post, all considered none-the-less outperformed and over-treating procedures.

Fabrication
Inlays & Onlays are fabricated with a CAD/CAM setup, that means a precise impression of the teeth is taken and the fabrication is custom made for the patient in the dental laboratory, while a temporary is in place.

Sophisticated synthetic resins (ie composites) exhibit outstanding mechanical and aesthetic properties, that almost confront ceramics. They are by default considered material of choice for the fabrication of inlays/onlays, unless contra-indications present.

They are coatings made of special, reinforced dental porcelain (porcelain veneer). They are placed on the front surfaces of the teeth. They are partial-coverage prostheses (the entire tooth is not covered) as opposed to crowns, which are full-coverage prostheses. Porcelain veneers are manufactured on high-precision machines (CAD/CAM) and are bonded to the front surface of the teeth using a special bonding technique. Their role is to treat discolouration and restore the shape and form of the teeth. Nowadays, the well-known sockets (see Prosthetic sockets) are considered very invasive, because they are full-coverage restorations (the teeth are grinded as a whole). Their use has been “displaced” almost completely by porcelain veneers and veneers & overdentures (See Veneers & Overdentures). Porcelain veneers require minimal or no cutting (hyper-conservative restorations) of teeth.

  • when we want to close spaces between the teeth that are sparse (spacing).
  • to correct the position of front teeth – if orthodontic treatment is excluded – e.g. in a crowd
  • when we want to restore the shape of the teeth. This applies to patients whose teeth are worn down (abrasions) or who have broken teeth
  • to cover teeth, which bear extensive fillings
  • when we want to “reposition” a tooth in its correct position, which is located “further in” than the rest.
  • to “whiten” the teeth permanently in combination with chemical teeth whitening techniques
  • when we want to “fill” the unruly lips and cheeks

  • They are partial coverage restorations and therefore absolutely conservative compared to other full coverage prosthetic restorations (crowns – sockets) (See Prosthetic sockets)
  • They give more homogeneous surfaces on the teeth, better gloss, as well as very good macro- and micro-morphology.
  • Unparalleled mechanical properties (hardness, compressive and tensile strength). Under certain conditions a porcelain face can increase the resistance of the tooth to compressive and tensile forces (lateral).
  • Excellent optical properties
  • They are the solution of choice in all cases where resin veneers cannot be placed. (see Resin Veneers)
  • They can restore larger deficiencies than synthetic resin facings.
  • They are bonded to the enamel and dentin (bonding technique) and therefore do not affect the structural integrity of the tooth(s)
  • They are fully biocompatible and “friendly” with the periodontal tissues (gums)

  • Require intermediate steps and additional costs (laboratory etc.)
  • The bonding of porcelain veneers is a delicate and time-consuming process, as it requires absolute control of humidity (use of a dental buffer)
  • Very specific preparation and delicate handling is needed to maintain as much of the enamel surface as possible. Therefore the use of a surgical microscope or surgical loops is necessary) (see Office Equipment)
  • Because the thickness of the veneers is small, they are not suitable for covering discoloured teeth
  • A prerequisite for the selection of all-ceramic views is its proper evaluation:
    • the patient’s periodontal condition (gum and bone),
    • occlusion (the way the teeth come into contact with each other)
    • and the possible need for individual special treatments (cosmetic surgery).

The incident is examined and analysed. (appointment 1) The teeth that will receive the porcelain veneers are selected according to the aesthetic analysis of the smile and face (see Digital Smile Design). The proposed design is transferred onto the natural teeth with personalized guides and thus a direct simulation is made. (appointment 2) The final result is visualized in just 3 minutes without touching the teeth (appointment 2) The patient leaves and tries the simulation in the mouth for 2-3 days He returns to the office and if everything is ok, the shape is copied on the final porcelain veneers using special navigators. (appointment 3) The veneers are fabricated one by one on a special CAD/CAM guided design device.

The manufacturing stages of porcelain veneers include:

  • preparation of the front surfaces of the teeth
  • construction of transitional-temporary restorations
  • impression of the teeth
  • construction of final restorations of feldspar (feldspathic) or lithium bipyrite (e-max)
  • and their final welding in place
Porcelain veneers are used in almost the same cases as resin veneers, except that they deal with more extensive cases

They can be done without grinding under certain conditions; e.g. when the tooth is not discoloured and is not “chipped”. However, if we have dyschromic or ‘chipped’ teeth, the veneers need more thickness and grinding In these cases, where we do not have the option of non-grinding, a simple delineation is made on the tooth so that there is a specific position of placement (direction of insertion) of the veneer. This light “scraping”-demarcation is done without anesthesia. This creates an imperceptible socket, but it is able to prevent the porcelain veneer from being bonded to the tooth. In any case, even this light grinding is not considered harmful to the tooth and is done without anaesthesia

Usually, if there are no other aggravating factors (e.g. teeth clenching), they can stay in the mouth for 8-15 years. They have a longer life expectancy than composite resin veneers and deliver more stable aesthetic results. They are replaced when their border to the gums starts to become discoloured. They are again replaced with new porcelain veneers.

Prices for porcelain veneers range from 400 – 600 euros. They depend on the difficulty of each case (e.g. covering discoloured teeth, teeth grinding and clenching, etc.)