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.