Tuesday, June 2, 2009

Non prep veneers Vs prep veneers

In this post, I will talk about no prep veneers. At the end, I will discuss the advantages and disadvantages of this modality.



No prep veneers protocol:


  1. take polyvinyl siloxane impression without any preparation of the teeth

  2. send the impression to laboratory for veneers fabrication.

  3. When veneers are sent back from laboratory, no cord packing is necessary under gingiva since the margin of no prep veneers can be left at the gingival level or slightly under gingiva in order not to see the junction between the veneer and the tooth tissue. In order to achieve this goal, we can use materials like magic foam cord or Expasyl from (Kerr).

  4. Try in veneers using translucent shade adhesive bond

  5. Before permanent cementation, we clean teeth with pumice (preppies)

  6. Clean and dry very well before final cementation

  7. Acid etch all facial and incisal edge . We will have the strongest bond with no prep veneers since it is totally on enamel and no dentin bonding is needed.

  8. rinse etchant and dry the field. You should see frosty enamel surface

  9. We apply unfilled resin enamel bond with applicators, and then thin it with air.
  10. First we place the first central incisors then lateral and cuspids on each side.Lastly we place the bicuspids on each side.
  11. We cure the central incisor for 2 sec until jelly stage is formed so we can clean around the excessive cement around the gingival margin.
  12. We use this technique to avoid hurting the porcelain as in after total curing of the cement
  13. Floss between the interproximal surfaces of the central incisors. If floss does not go through, then we use serrated strips ( Axis), with safe sides to remove excessive cement between teeth.
  14. we perform the rest of curing on facial and lingual side if we wrap the incisal edge.
  15. we use scalpel blade#12 to go through the gingival margin and remove any little chunks left under the gingival sulcus that we were not able to remove with an explorer. we can use a carbide bur to go through under margin but the bur should not be spinning. This is another way to remove the cement without hurting or removing porcelain.
  16. Later, we use football carbide bur # 7408 to blend the veneers with the tooth tissue.
  17. We can use brownies from (Shofu), and run it on a handpeice as low as 13000 rpm to remove cement only without hurting the porcelain.

Advantages and disadvantages of No prep veneers:

It is an excellent option for people who has certain criteria. No prep veneers are done without anaesthetic shots. Moreover, we don not need to drill or remove any tooth structure.If patients criteria is not to remove any tooth tissue, then non prep veneers is the best option.On the other hand, If patient ask for perfection regarding tooth shape and size, prep veneers is the best option since non prep veneers will look a little bit bulkier.

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