Ceramic veneers are beautiful, aesthetically and functionally
exceptional restorations that can be life changing for many
patients. They are, however, relatively technique sensitive and
require careful treatment planning and execution. There are many
variations in clinical techniques ranging from extremely
conservative, removing little or no tooth structure, to relatively
radical, removing all of the facial enamel and most of the distal
and mesial enamel. There is, however, a growing consensus in the
literature that the greatest success will be had when the former
approach is adopted as the success or otherwise of a veneer is
largely dependent on the strength of the bond between the veneer and
the underlying tooth.
We recommend therefore that for the greatest chance of success, you
should keep as much of the preparation as possible in the enamel
layer. The following, additional guidelines will also help you
maximize your results:
- Inform the patient of other treatment alternatives, beginning
with the most conservative options eg orthodontics, tooth
whitening, enameloplasty etc.
- A diagnostic wax-up should be made and shown to the patient
prior to completion of the treatment plan.
- Only prepare teeth when the gingival tissue is healthy.
- If dentine is exposed during preparation, seal to prevent
sensitivity and bacterial invasion.
- All internal line angles should be rounded to prevent stress
that can lead to fracture.
- Margins should be placed supragingivally when possible.
- Provisional restorations, fabricated from the diagnostic wax-up,
should be developed to allow the patient to visualize the final
result.
- Follow closely adhesive techniques recommended by manufacturers.
- Avoid placing numerous veneers at the same time to prevent
micromovement and possible microleakage.
- Inspect margins and gingival adaptation and completely finish
and polish.
- Evaluate occlusion in centric, protrusive and lateral
excursions, adjust as needed and then repolish.
Smiles on Norton prefer the use of eMax for our metal free crowns.

