Laminate Veneers Overview
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Questions and Answers

What is the primary benefit of laminate veneers regarding tooth structure?

  • They conserve tooth structure by being confined to the enamel layer. (correct)
  • They replace the entire tooth.
  • They invade deeper layers of the tooth.
  • They require extensive tooth reduction.

Which of the following is NOT a disadvantage of laminate veneers?

  • High cost
  • Lack of repairability
  • Technique sensitivity
  • Reversibility (correct)

Which condition is an indication for using laminate veneers?

  • Severe malocclusion
  • Fractured incisal third of anterior teeth (correct)
  • Severe gum disease
  • Extensive caries on molars

What factor significantly influences the long-term success of laminate veneers?

<p>Adhesive cementation process (B)</p> Signup and view all the answers

What is a common reason for choosing laminate veneers over orthodontic treatment?

<p>For slightly malpositioned teeth (A)</p> Signup and view all the answers

Which of the following is a factor that can affect the bond interface in laminate veneers?

<p>Surface roughness of the enamel (D)</p> Signup and view all the answers

Which of the following conditions would least likely contraindicate the use of dental veneers?

<p>Minimal tooth wear (D)</p> Signup and view all the answers

Which of the following is an advantage of using laminate veneers?

<p>They preserve periodontal health due to supragingival finish. (A)</p> Signup and view all the answers

What is the primary reason for minimizing tooth preparation during veneer application?

<p>To preserve remaining enamel (A)</p> Signup and view all the answers

What is a major disadvantage associated with the preparation process for laminate veneers?

<p>It can cause irreversible tooth damage. (D)</p> Signup and view all the answers

What factor is crucial in improving the bond strength between veneers and luting materials?

<p>Etching with hydrofluoric acid (B)</p> Signup and view all the answers

Which ceramic characteristic is associated with better bonding behavior?

<p>High percentage of vitreous glassy phases (B)</p> Signup and view all the answers

Which of the following cement types is preferred for the cementation of ceramic veneers due to its working time and color stability?

<p>Light-polymerized luting composite resin (C)</p> Signup and view all the answers

What is a significant consequence of using self-polymerized or dual-polymerized resin cements over time?

<p>Darkening color of the veneer (C)</p> Signup and view all the answers

What is the success rate for veneers when bruxism or parafunctional habits are present?

<p>60% (C)</p> Signup and view all the answers

Which of the following is NOT considered a contraindication for veneer placement?

<p>Well-maintained oral hygiene (A)</p> Signup and view all the answers

What is the recommended depth for enamel removal during labial preparation?

<p>0.3-0.5 mm (A)</p> Signup and view all the answers

Which bur is suggested for gauging the amount of enamel reduction in labial preparation?

<p>No. 1 round bur (C)</p> Signup and view all the answers

How much of the preparation should remain on enamel to ensure an adequate seal?

<p>At least 50% (B)</p> Signup and view all the answers

What type of finish line is recommended for the marginal area during bulk reduction?

<p>Smooth chamfer finish line (D)</p> Signup and view all the answers

What is the primary purpose of wrapping the laminate margin into the embrasure area?

<p>To increase bond strength (B)</p> Signup and view all the answers

What is indicated for proximal contact areas adjacent to diastemata?

<p>Open the contact (A)</p> Signup and view all the answers

What is the depth of the proximal margin's smooth chamfer during proximal preparation?

<p>0.5 mm (D)</p> Signup and view all the answers

When preparing the proximal area, how far should the preparation extend into the interproximal contact areas?

<p>Halfway into the contact areas (C)</p> Signup and view all the answers

What is the first step in treating the tooth surface before applying the bonding agent?

<p>Clean the surface (D)</p> Signup and view all the answers

Which material is classified under silicate ceramics?

<p>Reinforced with leucite crystals (D)</p> Signup and view all the answers

Which of the following is NOT a common failure of laminate veneers?

<p>Materials being too hard (A)</p> Signup and view all the answers

What is the primary characteristic of silicate ceramics?

<p>Presence of quart, feldspate, and kaolin (D)</p> Signup and view all the answers

What is the purpose of applying phosphoric acid during the tooth surface treatment?

<p>To etch the tooth surface for better bonding (C)</p> Signup and view all the answers

What is the optimal thickness of porcelain to preserve if the incisal preparation aims to restore the original tooth length?

<p>1.0 mm (B)</p> Signup and view all the answers

Which finishing margin placement is ideal when treating tetracycline-stained teeth?

<p>Subgingival placement (C)</p> Signup and view all the answers

What is a key benefit of using an incisal wrap around design?

<p>Reduces shearing stress (C)</p> Signup and view all the answers

What is the recommended extension into the sulcus for finishing margins?

<p>0.5 - 1 mm (D)</p> Signup and view all the answers

What is the purpose of creating a rounded chamfer at the incisal/lingual junction during lingual preparation?

<p>To prevent shearing stress (D)</p> Signup and view all the answers

How much lingual chamfer is required in instances of overlapping design?

<p>0.5 mm (A)</p> Signup and view all the answers

What should be performed to facilitate separation of the die in preparing multiple adjacent teeth?

<p>Open the interproximal contact (A)</p> Signup and view all the answers

What is the minimum reduction required for incisal preparation to lengthen the teeth by 1 mm if rounding of the incisal edge occurs?

<p>0 mm (C)</p> Signup and view all the answers

What is the predominant element in Feldspates Porcelain?

<p>Silica oxide (D)</p> Signup and view all the answers

Which type of porcelain is reinforced with leucite?

<p>Reinforced Feldspates Porcelain (B)</p> Signup and view all the answers

What is the flexion resistance range for Reinforced Feldspates Porcelain?

<p>320-450 MPa (D)</p> Signup and view all the answers

In which type of restoration is Alumina Porcelain primarily indicated?

<p>Complete crowns (D)</p> Signup and view all the answers

What is the fracture resistance of Procera All-Ceram?

<p>680 MPa (C)</p> Signup and view all the answers

What is the hardness of Zirconium Oxide Ceramics measured in Vickers units?

<p>1200 Vickers (D)</p> Signup and view all the answers

Which of the following materials has a flexion resistance up to 600-800 MPa?

<p>In-Ceram Zirconium (D)</p> Signup and view all the answers

Ceramic laminate veneers can be made using which of the following materials?

<p>Any of the above materials (D)</p> Signup and view all the answers

Flashcards

Laminate Veneer Definition

A conservative method to improve the appearance of discolored, damaged anterior teeth. Thin, bonded ceramic prosthetics covering the visible part of the teeth.

Laminate Veneer Advantages

Aesthetic improvement, color change fix (even with failed bleaching), durability (bio, mech, chem), tooth conservation, and shape/position modification, speeds up treatment.

Laminate Veneer Disadvantages

Technique-sensitive, irreversible, expensive, complex preparation, lack of fixability, challenging provisionalization.

Laminate Veneer Indications

Used for discolored, damaged, or misshapen teeth that are not easily fixed by other treatments, or to address aesthetic needs.

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Veneers vs. Orthodontics

Veneers can be used as an alternative to orthodontics to improve the position of slightly misaligned teeth rather than using braces.

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Bonding Interface Factors

Key aspects related to the strength and durability of the bond between the veneer and the tooth.

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Veneer Preparation

Preparing the tooth surface for the veneer involves shaping/reshaping the enamel and often takes a good dentist.

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Veneer Diagnosis & Treatment Planning

Assessing the patient to understand issues, propose a treatment plan that will fix the issue, and match the patient's needs.

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Veneer Contraindications

Situations where using veneers is not recommended, due to potential issues with success rates, retention, or overall oral health.

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Bruxism and Veneers

Bruxism (teeth grinding) can significantly reduce the success rate of veneer bonding, often dropping it to 60%.

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Minimal Enamel Removal

During veneer preparation, minimizing enamel removal is crucial to preserve the tooth's strength and avoid fractures or debonding.

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Dentin Exposure and Veneers

Veneers bonded to a large amount of exposed dentin have a higher risk of failure compared to veneers bonded to supragingival (above the gum line) areas.

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Vitreous Ceramic Bonding

Veneers with a high proportion of vitreous glass are more likely to bond effectively with luting materials.

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Light-Cured Resin Cement

Light-cured composite resin cement is preferred for veneers due to longer working time and better color stability compared to other types.

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Post-operative Sensitivity

Teeth sensitivity after veneer bonding is a common concern when using adhesive cement techniques.

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Color Stability of Cements

Some cements, especially self and dual-polymerizing resin cements, can affect veneer color over time, causing darkening.

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Rubber dam use in dentistry

A rubber dam is used to isolate the tooth during treatment.

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Phosphoric acid etch

A chemical used to roughen the tooth surface, improving bonding.

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Laminate veneer failure types

Laminate veneers can fail due to chipping, poor esthetics, marginal issues, incomplete fit, debonding, caries, or hypersensitivity.

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Silicate ceramic types

Silicate ceramics, like feldspars and alumina porcelains, are used in dental laminates and have quartz, feldspate, and kaolin.

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Oxide ceramic types

Oxide ceramics, including alumina, spinelle, and zirconia, feature aluminum oxide or zirconium oxide composition for laminates.

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Labial preparation depth

Remove 0.3-0.5mm of labial surface, potentially up to 0.8mm for deep discoloration.

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Enamel preservation

Maintain at least 50% enamel in the preparation.

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Proximal preparation

Extend preparation halfway into interproximal contact areas, avoiding the contact point.

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Proximal contact management

Proximal reduction moves the margin into the embrasure, slightly lingual to buccal surface

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Chamfer finish line

Create smooth chamfer finish lines (0.3-0.5 mm deep) for proximal margins, and slightly labial (0.2 mm) to contacts for minimal shade difference.

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Diamond bur grit

Use coarse diamond for bulk reduction for added retention and light refraction; Use fine-grit diamond for a smooth, definite finish line, enhancing seal.

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LVS Dimensions

The LVS (likely Labial Veneer System) bur sizes are 0.5mm and 0.3mm.

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Diastemata

Contact areas adjacent to diastemata (gaps between teeth) need to be opened.

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Marginal Fit Evaluation

Assessing how well the restoration fits into the preparation.

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Finishing Procedures

Procedures to give a precise and smooth finish to the restoration.

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Home Care Access

Evaluation on how easy it is to maintain the margins of the restoration by the patient during home care, important for self cleansing areas.

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Incisal Preparation Window

The recommended incisal preparation for direct and indirect composite veneers.

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Incisal Wrap Around

Incisal preparation extending around the incisal edge by 1.0-1.5 mm, used if the tooth lengthening is needed.

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Incisal Reduction Amount

The amount of incisal reduction depends on the desired length of the restoration.

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Sulcular Extension

Placing the finishing margin just within the sulcus, typically 0.5mm to 1mm extending into the sulcus and modifying the chamfer.

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Lingual Preparation

Refinement of the lingual enamel to avoid butt joints; a rounded chamfer is necessary when the design overlaps.

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Heterogeneous Dental Ceramics

Ceramics composed of crystals embedded in a glassy matrix (vitreous phase).

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Feldspathic Porcelain

A type of dental ceramic where silica oxide (quartz) is the primary component. Classified into conventional, leucite-reinforced, and lithium oxide-reinforced varieties.

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Alumina Porcelain

Dental ceramic with a high proportion of aluminum oxide (less than 50%), typically used for complete crowns.

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Oxide Ceramics

Polycrystalline ceramics with minimal or no vitreous phase. Due to their opacity, they're often used as internal copings in ceramic restorations.

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Aluminum Oxide Ceramics

Oxide ceramics with a high aluminum oxide content. Examples: In-Ceram Alumina, In-Ceram Zirconium, In-Ceram Spinelle.

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Zirconium Oxide Ceramics

Polycrystalline ceramics with a tetragonal structure, stabilized with yttrium oxide. Known for their strength and absence of porosities.

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Ceramic Laminate Veneers

Thin ceramic layers bonded to the front of teeth to improve their appearance. Made from glass-based, aluminum oxide, or zirconium oxide ceramics.

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Veneer Material Selection

Choosing the right ceramic material for veneers depends on the patient's needs and oral conditions (e.g., esthetics, strength).

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Study Notes

Laminate Veneers

  • A conservative method for restoring the appearance of discolored, pitted, or fractured anterior teeth.
  • Thin-bonded ceramic prosthetics that restore the facial and some proximal surfaces of anterior teeth requiring aesthetic treatment.
  • Adhesive cementation is critical for long-term success.

Objectives

  • Definition: Laminate veneers are thin ceramic coverings for teeth to improve cosmetic appearance.

  • Advantages & Disadvantages: Advantages include aesthetics, durability (biological, mechanical, and chemical), tooth conservation, and modifiability. Disadvantages include technique sensitivity, high cost, complex preparation, limited repairability, and difficulty with provisionalization and color matching.

  • Indications & Contraindications: Indications include discolored non-vital teeth, teeth with extensive cervical restorations, stains not removed by other means, color defects (like amelogenesis imperfecta, tetracycline discoloration), physiological aging, trauma, and shape abnormalities. Contraindications include bruxism, severe tooth attrition, teeth with insufficient enamel, extensive existing restorations, severe malocclusion, severe discoloration, poor oral hygiene, and bad oral habits.

  • Factors affecting the bond interface: Tooth preparation, ceramic material and resin cement.

  • Diagnosis and Treatment Planning: Proper diagnosis of color changes, rubber index for evaluation, diagnostic wax-ups, study models, intraoral radiographs, and photographs are critical. Ortho treatment, crown lengthening, and gingival recontouring may be considered

  • **Teeth Preparation:**Minimal enamel removal, definite chamfer seat for guiding veneer placement, creation of receptive enamel surface for etching and bonding. Removing outer fluoride rich layer and allowing sulcular margin placement in discolored areas.

  • Impression: Poly-siloxane-based impression material for custom/stock trays. Digital impressions for CAD/CAM. Retraction cord positioning exposes the finish line.

  • Provisional Restoration: Provisional restorations are made as one piece, spot etching is done at central facial surface, followed by bonding resin and resin cement for attachment; crystal-clear celluloid ready-made crowns are suitable options.

  • Try-in: Using water-soluble viscous pastes or glycerin to hold the laminate and seat it with pulsating movements, then checked for thickness, contour, shade, and marginal accuracy. Occlusion should be checked in centric position and protrusive mandibular excursion. Excessive finger pressure should be avoided.

  • Bonding Steps: Sandblasting and acid etching of the porcelain surface. Application of silane coupling agent, phosphoric acid etch, rinse and dry, apply bonding agent, light cure

  • Laminate Placement Instruments: Specific instruments for holding and placing veneers.

  • Finishing: Procedures to give the final shape and polish the veneer. Details needed to avoid failure.

  • Failure of Laminate Veneer: Possible causes include chipping and fracture, poor esthetics, decreased marginal integrity, discoloration, incomplete fit, debonding, caries, and hypersensitivity.

  • Choice of Ceramic Material: Materials vary for different requirements; considering that some are better suited for resolving slight alterations in color. A classification of ceramics based on composition is used to define best option for each case. Feldspathic Porcelain, Alumina Porcelain & Oxide Ceramics.

  • Fabrication of Veneers: Methods may include feldspathic porcelain baked in traditional water-slurry method, castable glass ceramics, heat pressed ceramics, and CAD/CAM processed "factory produced ingots".

  • Esthetics & Strength Considerations: Tables summarizing esthetics and strength associated with specific material/fabrication method.

  • Special Situations: Addressing pre-existing restorations, masking discoloration, and managing thin teeth.

  • Incisal Preparation: Method for incisal reductions to adjust for existing structure or to add to length. Avoid areas where masticatory function might impact the junction of the veneer.

  • Sulcular Extension: Placing finishing margin just within the sulcus to limit extension needed into sulcus, and adjusting for tetracycline stains.

  • Proximal Preparation: Methods for proximal reductions with specific instruments such as LVS (labial veneer system) to address contact point areas.

  • Lingual Preparation: Modification of lingual surfaces for optimal fitting of the incisal/lingual junction in cases with existing overlaps.

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Description

This quiz explores laminate veneers, a conservative method for improving the appearance of anterior teeth. It covers their definition, advantages and disadvantages, as well as indications and contraindications for use. Test your knowledge on this aesthetic dental treatment.

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