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The Nuts & Bolts of Veneers

TODD C. SNYDER, DDS, FAACD, FIADFE, ASDA

Accredited Fellow, American Academy of Cosmetic Dentistry

Fellow, International Academy for Dental Facial Esthetics

Member of The American Society For Dental Aesthetics

Former Faculty, UCLA Center For Esthetic Dentistry

LEGIONpride.com, Online Training Challenge for Dentists

Todd Snyder, DDS, FAACD, FIADFE, ASDALaguna Niguel, CA

Aesthetic Dental Designs®

doc@tcsdental.com

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TREATMENT PLAN

• LEAST INVASIVE

• STAY IN ENAMEL WHENEVER POSSIBLE

• CAN WE MOCKUP CASE?

• OCCLUSION

• EXCURSIVE MOVEMENTS

Minimally Invasive Veneers…. Why? Benefits??

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DIAGNOSTICS

• DIAGNOSTIC PHOTOS

• DIAGNOSTIC WAXUP

• DUPLICATION OF WAXUP

• BEADLINE TECHNIQUE USED ON MODEL

• TAKE AN OVER IMPRESSION OF THE MODEL

Beadline Provisional Mockup

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Mockup

labial reduction options Depth Limiting Burs - Brasseler USA

Average enamel thickness

At CEJ .3-.4 mmMiddle third .8-1.0 mmIncisal third 1.1-1.3 mm

Veneer Preparations

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Preparation Reduction• Depth reduction burs

• Safe reduction

• Lasco

Veneer Preparations

Independent Depth Cuts (Lasco Burs)

▪ Depth Cuts▪ Tooth Reduction▪ Interproximal & Margins▪ Retention Form (Line of Draw)

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Burs• Organization

• Diamonds

• Carbides

◼ K0096 Finishing Kit $126.47 each

◼ K0095 Preparation Kit

$125.47 each

Preparation

Aesthetics

Function

Bonding to Enamel

Material Options

Minimal Prep Case: 2

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Minimal Prep Case:

Wax-up Case:

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Preparation Guides:

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Depth Cuts

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Photos for Laboratory Technician

Provisional Restorations

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Final Restorations

Provisionals Mimic The Final Restorations

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PREPARATIONS

• DIAGNOSIS

• TX PLAN

• PREPARATIONS

• PROVISIONALS

• TRY-IN

• CEMENTATION

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Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

• Retention Form (Line of Draw)

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

• Retention Form (Line of Draw)

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

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Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

• Retention Form (Line of Draw)

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

Veneer Preparations-Feldspathic Porcelain

Depth cuts of 0.2mm-0.8mm*

1.0mm-1.5mm incisal reduction*

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Veneer Preparations-Pressed Ceramics

Instant Ortho/Un-Rotating Teeth

• Do initial workup

• Diagnostic preps

• Diagnostic waxup

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

◼ Sequence

– Reduce all excess tooth structure

– Ideal reduction

– Margin placement

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Incisal edge preparations

a) No incisal lengthening

b) Changing color or wear

c) Lengthening tooth

Veneer Preparations

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

Preparation Reduction• Depth reduction burs

• Safe reduction

• Lasco

Veneer Preparations

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Independent Depth Cuts (Lasco Burs)

▪ Depth Cuts▪ Tooth Reduction▪ Interproximal & Margins▪ Retention Form (Line of Draw)

Burs• Organization

• Diamonds

• Carbides

◼ K0096 Finishing Kit $126.47 each

◼ K0095 Preparation Kit

$125.47 each

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PROVISIONALS

• DIAGNOSIS

• TX PLAN

• PREPARATIONS

• PROVISIONALS

• TRY-IN

• CEMENTATION

Simplified Provisionals**

Siltech Putty Matrix

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Bead Line Veneer Provisional Restorations. Pract Proced Aesthet Dent 2009;21(3):E1-E7.

Cosmetic Provisionals (Bead Line Technique)

Cosmetic Provisionals (Bead Line Technique)

Scribe a 0.5mm-1mm groove into tissue & a little on tooth

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Cosmetic Provisionals (Bead Line Technique)

Cosmetic Provisionals (Bead Line Technique)

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Cosmetic Provisionals (Bead Line Technique)

No Polish Necessary if you use a good model

Cosmetic Provisionals (Bead Line Technique)

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Cosmetic Provisionals (Bead Line Technique)

Cosmetic Provisionals (Bead Line Technique)

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TRY-IN

• DIAGNOSIS

• TX PLAN

• PREPARATIONS

• PROVISIONALS

• TRY-IN

• CEMENTATION

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What Percent of Impressions per

Laboratories have visible

errors?

89%

1-Samet N, Shofat M, Livny A, Weiss EI. A clinical evaluation of fixed partial denture

impressions. J Prosthet Dent 2005; 94:112-117.

And the key to remember, routinely, it’s voids, bubbles, and tears

“Approximately 90% of impressions have defects” G. Christensen

▪ Superoxol

Epinephrine

Ferric Sulfate

ViscoStat 20%

Astringent 15.5%

▪ Aluminum Chloride

Viscostat Clear 25%

Expa-syl

Hemostasyl

▪ Aluminum Sulfate

Tissue Goo 25%

▪ Various Cords

Astringents Enhancing Moisture Control

Fluid/Tissue Management

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Fluid/Tissue Management

Fluid/Tissue Management

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▪ Contact lens effect

At or above gingiva

▪ Masking tooth or color

changes

At gingiva, then place cord

and reduce another 0.3-0.5

mm

Veneer & Crown Margin Placement

Fluid/Tissue Management

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Lasers (Diodes) Fast

Hemostasis

No crevicular fluid

No cord

Better healing

Enhancing Moisture Control

Fluid/Tissue Management

Features

• Number #1 dental laser in the world

• More power – 3 watts

• New easy to use presets

• New treatment timers for perio treatment

• Wireless foot control

• Optional battery pack

• Perfect for first timers or hygienists

• Affordable

• Disposable tips or fibers

• Certification included

• MSRP: $4,495

• CE Price: $3,495

Use code

CESNYDER18

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Make cases easyIdentium for multiple teeth

Make cases easy, make your patients happy

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Make cases easy, make your patients happy

RESTORATION PLACEMENT?

• Bonded

• Margin placement

• Moisture Control

• Technique Sensitive

• Materials

• Self Adhesives

• Bonding agent (TE or SE) & luting resin

• Cemented

• Margin placement

• Moisture Tolerant

• Retention Required

• Materials

• RMGI

• Ceramir

Cement Selection

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RESIN CEMENT COSMETIC CASES….

COSMETIC CASES….

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COSMETIC CASES….

COSMETIC CASES….

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COSMETIC CASES….

COSMETIC CASES….

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COSMETIC CASES….

COSMETIC CASES….

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COSMETIC CASES….

COSMETIC CASES….

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PROVISONALS

PROVISIONALS

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CERAMIC TRY-IN

• Make sure it is etched properly from lab

• Ceramic Primer prior to try-in (unless using Ceramir)

• Ultrasonic with ethanol after try-in

BONDS WITH OR WITHOUT HF

ACID ETCHING

THE “NO-WATER” SILANE w/ MDP

INSTANT ACTIVATION

LESS DEGRADATION

(More Stable 2 Year Shelf-Life)

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Silanes

Universal Adhesives (w/MDP)

Silane Primer + MDP

Organo-Phosphate Monomer (MDP)

Silane Primers

A disadvantage of many other silane products is that they are pre-

hydrolyzed.

Another disadvantage is some require the use of Hydrofluric Acid

etching and sometimes in addition to Micro-Etching. The new

Monobond Plus requires HF and Micro-Etching as well as 60 minute

activation time period.

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TRYIN APPROVAL

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3 VITA® shades

2 chromatic shades

LITHIUM DISILICATE & SILICATE, LEUCITE AND FELDSPATHIC

RESTORATIONS

IS AN ADHESIVE CEMENTATION

SYSTEM THAT IS EASY-TO-USE,

EFFICIENT AND HIGHLY

EFFECTIVE

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FINAL RESTORATIONS

Veneer Finishing System

Send CONTACEZ to 24587 to request a sample.Using the code SNYDER20 on their website will get attendees 20% off their next order!

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Jiffy Saws (Ultradent)

• More efficient than Halogens

• Halogen produces light from 370 to 800 nm then filters out all

but blue light in 400-500 nm range

• Longer lasting / Cordless / Batteries

• Faster curing (5 seconds)

• Smaller in size/lighter

• Less heat

BENEFITS OF LED LIGHTS

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Comparisons - Lights

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VALO DELIVERS

Access to the curing site = Energy to the resin

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Machined from Aerospace Aluminum

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• Design• Power• Durability• Access• Posterior tooth• Broad Light Output Range

– 395-480nm

• Cost• Weight

What Percent of Impressions per

Laboratories have visible

errors?

89%

1-Samet N, Shofat M, Livny A, Weiss EI. A clinical evaluation of fixed partial denture

impressions. J Prosthet Dent 2005; 94:112-117.

And the key to remember, routinely, it’s voids, bubbles, and tears

“Approximately 90% of impressions have defects” G. Christensen

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▪ Superoxol

Epinephrine

Ferric Sulfate

ViscoStat 20%

Astringent 15.5%

▪ Aluminum Chloride

Viscostat Clear 25%

Expa-syl

Hemostasyl

▪ Aluminum Sulfate

Tissue Goo 25%

▪ Various Cords

Astringents Enhancing Moisture Control

Fluid/Tissue Management

Fluid/Tissue Management

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Fluid/Tissue Management

Fluid/Tissue Management

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Lasers (Diodes) Fast

Hemostasis

No crevicular fluid

No cord

Better healing

Enhancing Moisture Control

Fluid/Tissue Management

TODD SNYDER(949) 643-6733

doc@tcsdental.com

www.aestheticdentaldesigns.comwww.drtoddsnyder.com

www.toddsnyderracing.com

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