Thanks doc for the entire series on veneers , touching upon all the aspects of veneers . This one, is at a time when veneers are fast gaining space in our practice and we are needing to update.
well done. you explained truly in a nice way the problems with undercuts when the insertion path of the wrap veneer is vertical and not horizontal/oblique as in previous situations. it helps me a lot to use the pencil and draw the internal prep angle: if i see a continuous black line from the incisal p.o.v. it means i'm done with adjusting the prep and removing undercuts. keep on posting your videos, dr. Stevenson. this is the best dental operative channel on the tube, by far! greetings from italy
Doc, been doing veneer cases for over 15 years and learning a LOT from your videos. How do you adjust prep style for minimal reduction IF the patient has small interproximal composite restorations (composite from F😁 to L)? I never like to end a veneer margin on composite, however i equally dislike prepping for full coverage. Thanks in advance!
THANK YOU! If this is a small class III, I usually leave the margin on the restoration, thus breaking the rules, but because it is small there will be minimal negative impact on the strength of the final veneer-tooth complex. I will replace the composite during the prep to make sure it is sound and will replace them as necessary over time if they show leakage.
Dr. Can I ask you; let's say there are restorative on the teeth you want to have veneers on, what is the protocol? Do you remove the fillings and replace with new fillings and the prep for veneers or what do you do? Also, in case of larger fillings, do you still go for veneers in the aesthetic zone or do you mix veneers and full crowns/onlays/Inlays etc? How do you decide that? Thanx so much for your videos and quick answers. We learn so much from you!
I prep past small filling and sometimes allow the residual composite to remain (under the new veneer) if the composite is intact and well-sealed. Otherwise, I replace it with a composite that matches the shade of the prepared tooth. With large fillings, I usually disassemble them first and assess the remaining structure...sometimes I can perform a super veneer that wraps significantly around the tooth - almost like a crown, and treat it like a veneer during cementation.
Thank you so much for this awesome video. If patient just wants to close the diastema (no lingual defect or existing restoration present on tooth), is the palatal wrap still required or can you just do incisal butt joint finish on the incisal like your previous video? Thank you in advance!!
Thanks for a video. I've got a question about diastema: usually, there is a large gingiva papilla between two teeths. So do deal with that? As I know - you need to make a prep under the gingiva, so that the future veneer will push the papilla to the top and it will get the right form. But on the video you didn't make a prep under the gingiva. Thanks!
1st I'd like to thank you for the awesome video series on veneer preparation. I'd like to know the reason for not having the same wall you made on the distal for the mesial as well(10:17). Can't we make a little wing-like wall for mesial too or this is the way of preparation for Diastema closure? Thanks a lot
Thanks for all the knowledge dr, but why the disk? I truly can't risk it and i don't see much of a benefit from it. Please explain if possible, much thanks and regards.
Doctor, when we were preparing the crown, each one of its accessories had specific measurements, so here is it the same thing? I mean the veneers are what they are made of?? I mean Just E-max???and if there another materal all them will fit in this measurments??
What if there is no enamel left on the lingual side of # 8 & 9 but the front of those teeth have perfect enamel and esthetics? Anyway to make a restoration adhere to the lingual side?
As long as you can have an enamel periphery on the lingual, and leave the majority (70-80%) of the enamel on the facial it may work with IDS, however, these cases are often complicated by erosive vulnerability (from Airway issues, emesis, etc) and lack of functional space. Usually, orthodontics will help create adequate lingual space, but a larger issue vis-a-vis the root cause is not determined and they fail prematurely. It's not bruxism. Great question - a complex solution.
How far are the outlines palatinal, when considering the occlusion and articulation movement? What to do with the cuspids when having cuspid articulation?
I don't design the veneers with MIP in mind - the bonded ceramic will be incredibly strong under compressive loads. Much more important is what functional pathways may do to the veneers, especially if they are designed incorrectly. I have the patient in prototypes and modify pathways until they are not interfering, then capture this modification as a new scan and send it to the lab for veneer fabrication. In dental school, we were all taught never to place a margin in occlusion. Oops, not true. It's all about force management and the way in which materials fail under stress. MIP is not one of the concerns...
Is it necessary to have lingual wrap over incisal butt for cases that have diastema and interproximal restorations? Can't we just do incisal butt with interproximal slicing preps?
The book I am reading for veneers say that for incisal lapping feature we have to make notch on medial and distal incisal angles and then they are extended through incisal angles faciolingually WHAT DOES THAT MEAN?
It's a channel/notch/groove from the facial to the lingual - it allows a rounded transition over the mesioincisal and distoincisal line angles into the proximal to the facial transition. Hard to describe in words, but may be seen in this video. Essentially you don't want a weak area - it looks like a crown prep in the top 1 mm of the prep as viewed from the facial. LOOK at 10:30 in the video.
Dr. Stevenson, For diastema closures you don't necessarily need to break through the interproximal contacts, do you? Just as long as the prep design is finished more lingual to the desired interproximal contact point that should suffice, right? Or should you break through the contact?
Okay, when there is a diastema, there is no contact, so I think what you are asking is "where should the interproximal finish line be located?" Answer: the best position is at the linguoproximal line angle, which will allow for a smooth contour change from the lingual into the contact area. If the prep does not extend this far, one of two things will occur: 1. the contour will be sudden and leave a potential plaque trap, or 2. the veneer must be made extremely thin to feather into unprepared areas. The thin veneer will be more difficult to make, will add bulk to the lingual and is commonly plagued with irregular margins.
@@StevensonDentalSolutions Oh, I actually meant to say for black triangle cases, not necessarily with diastema if the teeth are already in contact. Would you break through the interproximal in this case, or would you just finish your preps lingual to the desired contact area?
In the US we mostly use the Butt Joint Design (preferred) and the Lingual wrap only when required to include defects, or a major contour change, which may require a more lingual margin placement on the lingual. Take a look at PART 3...
