Veneers Teeth Pros and Cons: A Comprehensive Guide

Veneers Teeth Pros and Cons: A Comprehensive Guide

What are the types of veneering materials? Describe their advantages, disadvantages and indications. Add a note on the recent advances in veneering materials used in fixed partial dentures.

Veneers are thin facings of porcelain or resin affixed directly to teeth using a composite resin-bonding agent.

Types of Veneering Materials

• Porcelain veneers (Cerinate, Porcelite and Chameleon).
• Resin veneers by direct technique (Durafill, Heliosit, Silux).
• Resin veneers indirect technique (Dentacolor, Isosit).
• Composite veneers are direct and indirect (Visio-Gem).
• Composite reinforced with glass fibers (Targis/Vectris, Variolink II System).
• Castable hydroxyapatite (Cast apatite).
• Injectable ceramics (Dicor, Cerestore).

Read And Learn More: Fixed Partial Denture Short Essay Question And Answers

Comparison of Veneer Systems

Direct composite veneers

• Require only one appointment.
• The shade, contour, and final form can be corrected to the dentist’s and patient’s satisfaction.
• Less expensive when compared to porcelain and other laminate systems.
• Direct veneers can be repaired easily.

Indirect resin veneers

• The indirect resins have better bond strength than direct resins.

Porcelain veneers

• Have good translucency.
• Reduced plaque adherence.
• They can be fabricated only by indirect technique.
• Their advantages are that chair side time is reduced even for placement of multiple units.
  Have optimum color stability, esthetics, wear resistance, and tissue compatibility.

Porcelain Laminates

• Porcelain laminates are thin facings constructed on refractory dies
• The porcelain veneer’s inner surface is etched with hydrofluoric acid and bonded to the tooth with composite resin cement.

Veneering Materials Indications

• When a patient demands high esthetics
• For mildly stained tooth
• Enamel defects and diastema.

Veneering Materials Contraindications

• In dark stains
• Patients with parafunctional habits.

Veneering Materials Advantages

• Highly esthetic
• Good bond strength
• Resistant to abrasion and fluid absorption
• Good periodontal health.

Veneering Materials Disadvantages

• The fragile veneer can break
• Loss of glaze while finishing
• Technique sensitive
• Expensive and extensive tooth preparation.

Different technique

• Platinum foil is burnished onto the die on which porcelain is applied
• This prevents build up of heat during firing and increases surface area for etching.

Steps before bonding

• Check for fit of veneer.
• Color check:
  Place laminate on a tooth with glycerine and compare it with the shade tab. If laminate appears darker then select a lighter shade composite luting agent.
• The actual composite is placed and trial-checked.
• Clean the veneers and isolate the tooth.
• The etched surface of veneer is applied with silane coupling agent.
• The tooth is cleaned and enamel etching is done with 30–37% phosphoric acid for 15–20 seconds.
• The tooth is cleaned, isolated again and light light-activated dentin bonding agent is applied.
• The veneer is seated with composite cement and cured.
• Lingual finishing and occlusal equilibration is carried out.

Variations

Rochette’s bridge with lingual retainers and interproximal retainers.

Resin Veneer Direct Technique

Indications

• For dark stains
• Patients with parafunctional habits.

Resin Veneer Direct Advantages

• Good esthetics, if color blending can be done
• The longevity is equally good for recent resins when compared to porcelain
• Easy to repair.

Resin Veneer Direct Disadvantages

• Can produce staining
• Less abrasion resistant.

Resin Veneer Indirect Technique

Indication

• Mildly stained or striated teeth
• For patients with parafunctional habits.

Resin Veneer Indirect Advantages

• Can be used in patients with parafunctional habits
• Can be adjusted with ease.

Resin Veneer Indirect Disadvantages

• Can produce staining
• Less abrasion resistant.

Indirect Composite Veneers

Indications

• Enamel defects
• Diastema closures.

Indirect Composite Veneers Advantage

• Easy preparation.

Indirect Composite Veneers Disadvantage

• Less bond strength.

Technique

• Intra-enamel preparation or extra-enamel preparation can be done.
• Intra-enamel preparations are more accurate.
• Shade selection of body and incisal shades is done and impression is made after gingival retraction.
• Die is fabricated and the veneer is made.
• At the second appointment, the seating is evaluated and the veneer is bonded with a mixture of Visi-fil (75%)/Visio-bond (25%) blend.

Recent Advances In Veneering Materials

Reinforced composites

Encore Bridge

• The composite superstructure is bonded with porcelain veneers
• It is composed of 81% filled composite with a glass fiber reinforcement (Sculpture/FiberKo, Jeneric/Pentron, Inc)
• The framework has sufficient flexure to attain a Class I mobility
• An all-porcelain bridge will not allow flexure.

Advantage

Tooth Preparation is minimal (only on lingual surface with a small proximal extension).

Technique

The preparation starts 1 mm from the most distal aspect of the lingual surface and extends into the proximal area.

Bonding the Framework

After verifying the fit, the framework was bonded into place with C&B-Metabond (Parkel I), after which the veneers are bonded onto the composite pontics with UltraBond (Den-Mat).

Targis/Vectors

A product from Ivoclar Williams.

Composition

It is a glass fiber-reinforced composite, with silanized glass fibers, a BIS-GMA matrix, and an 85% ceramic-filled composite veneer.

Advantages

• Class 1 flexure attainable
• Good fracture resistance
• Esthetic properties comparable to metal-free ceramic restorations.

Variolink 2 System

A product from Ivoclar Vivadent.

Technique

• After sandblasting the veneer under surfaces, they are silanated with Monobond-S.
• The teeth are now isolated, and the preparations are etched.
• The enamel is etched for 30 seconds and the dentin for 5 seconds.
• The etchant is thoroughly washed away and the preparations dried.
• Syntac dentin primer is applied for 15 seconds.
• Teeth are dried.
• Syntac dentin adhesive is then applied for 10 seconds and dried.
• Heliobond (Ivoclar Vivadent) is applied to the tooth and the undersurface of the veneer inlays and luted with Variolink II cement (which has different consistencies and shades) and cured.

Castable hydroxyapatite

Synonym: Cast apatite.
Hydroxyapatite mixed with composite fibers is slip cast by vibration.
Studies are yet to prove its clinical use.

Injectable ceramics/Castable ceramics
(Dicor, Cerestore)

Dicor (Tetrasilicic fluoromica)
It was earlier used for FPDs, inlays, and onlays. Recently, it is used for laminate.

Indication

Laminates for periodontally compromised patients.

Contraindication

In short clinical crowns.

Castable Hydroxyapatite Advantages

• Good strength
• Good marginal adaptation
• Biocompatible
• Highly esthetic
• Low thermal conductivity.

Castable Hydroxyapatite Disadvantage

• Tooth preparation is extensive.
  Cerestore (shrink free ceramic system)

Indication

For periodontally compromised patients.

Ceramics Advantages

• Good flexural strength
• Highly esthetic
• Good marginal fit.