Den-Mat Guest Editorial: Minimum Prep Veneers For All Occasions By: Michael Pilon, DDS, DDPH

When we think of veneers we often think of wall-to-wall treatment. And this is an excellent option if conditions are ideal. Ideal includes patient acceptance, no financial constraints and occlusal and functional considerations. There are, however, some circumstances where a limited number of veneers can accomplish a considerable service to the patient. This article describes two such cases.

MISSING LATERALS:
In the first case the patient was concerned about the diastemas and overall unpleasing appearance of his maxillary canines and centrals (Fig. 1). His occlusion was such that Cerinate Veneers were an ideal treatment option. Cerinate Veneers serve as a minimum prep alternative to traditional veneers that require the reduction of tooth structure. The veneers were prepped to a depth of about 0.25mm. No anesthesia was needed nor was temporization. Cerinate Smile Design Studio was given instructions to close the diastemas, to contour the canines to emulate laterals and to balance the proportion of the teeth to each other. In concurrence with the patient, we chose a lighter shade even though the shade would be lighter than the rest of the teeth. His smile line is such that the other teeth did not show significantly (Fig. 2).

In an ideal situation, I would have extended treatment to include the bicuspids but the patient felt this was not a pressing need. But, on several occasions patients asked for further treatment once the Cerinate Veneers had been placed as the effect was so pleasing.

LOWER VENEER
In the second case, the patient was concerned about the appearance of the diastemas between the lower incisors. It is apparently a familial characteristic (Fig. 3). I am extremely hesitant to place crowns on lowers. In this case, the upper and lower incisors were not in occlusion in centric position so minimum prep Cerinate Veneers were ideal. The teeth were reduced 0.25 to 0.5 mm with care taken to reduce the incisal height about 0.50 mm so that there would be no contact with the maxillary incisors in centric. In veneers a heavy anterior contact can result in fracture.

Surprisingly, I saw the patient in a social setting about a month after the insertion. He said, “I want to discuss these veneers with you … I’d like you to do the uppers.” When I placed the upper veneers I noted the left central was not even, the patient interestingly felt it looked natural so we kept it that way (Fig. 4).

CONCLUSION
Minimum preparation veneers are an excellent option to have in one’s armamentarium. The advantages include the conservation of tooth structure, they are excellent from an aesthetic point of view and they offer good function and longevity in situations where there is no heavy contact in centric. They also offer the practitioner an opportunity to indulge in a bit of creativity while conserving tooth structure. I have found that when presenting the veneer option explaining they will look great, will last and require little reduction is wonderful encouragement for patients to proceed with treatment.

MATERIALS USED:

Cerinate Veneers

Cerinate Conditioner

Cerinate Prime (silinating agent)

Etch ‘N’ Seal

Tenure A and B

Ultra-Bond

Special Thanks to the Cerinate Design Studio in Santa Maria, California for their consultation services and support.

Dr. Pilon is a McGill graduate. He practiced in the Royal Canadian Dental Corps for 20 years. During this time he was on bases across Canada and in Cyprus with the UN Peacekeeping team. He had various appointments, base dental officer, Hygiene course director, Director of Dental Officer Summer training and he earned his wings with the Canadian Airborne Regiment. He entered private practice in Ottawa 15 years ago and enjoys most aspects of practice except Orthodontics.