Porcelain Veneers

Porcelain veneers are thin facings of porcelain bonded to teeth to correct aesthetic deficiencies. Teeth are the centerpiece of beauty – our appearance is a communication. Unsightly teeth cause visual tension. Beautiful teeth denote inner vitality. Porcelain veneers are used to correct aesthetic deficiencies like:

1. Dark triangles
2. Tetracycline staining
3. Teeth refractory to bleaching
4. Worn down teeth
5. Irregular teeth
6. Fractured tooth/teeth
7. Teeth with spaces

Porcelain veneers are some of the strongest restorations we place. Porcelain veneers are of several types. Their use depends upon the aesthetic and functional needs of the patient.

Feldspathic (Power Liquid) Type:
These are the traditional type of veneers. I prefer them for their optical qualities. This method uses a porcelain powder and a wet brush to sketch the porcelain. Less tooth reduction is required for this type of porcelain, which is my primary focus. When the veneer can be confined to the enamel (the first layer of the tooth), it is ideal.

Pressed Ceramic: 
These veneers require more reduction. I prefer to use this material in patients who exhibit horizontal cracks on the tongue side of their teeth, and various other factors which increase stresses on the tooth. These veneers are made with a lost wax technique and used in the manufacture of metal restorations. As opposed to the powder liquid technique, an ingot of ceramic is pressed into the mold and then the ceramist cuts back and adds more porcelain layers to achieve the desired optical effects.

Which technique is better?

Both. Excellent results can be obtained with either one of the techniques. Each case has its own requirements, and we decide on a case by case basis. My basic thought process for material selection works as

1. What is underneath this restoration?
2. What is the potential for flexure?
3. Can I protect the internal surfaces?
4. What are the stresses applied?

If I cannot get a predictable bonding surface, I will lean towards a crown as opposed to a veneer. If a tooth protrudes out of the dental arch and we are forced to reduce well into the dentin I will consider a crown.

Dentin is a continuation of the dental pulp (tissue comprising of nerves and blood vessels). It is half mineral and half protein. Bonding to dentin is not as predictable a surface to bond as enamel is. This is owing to the varying density of its tubules.

Oral fluids are corrosive; ceramics are porous and weaken over time. Ceramics can lose up to 50 percent of their strength over time.