In the first appointment dentist evaluates the condition of teeth and determines the need for placement of veneers. For this purpose, dentist may get your photographs clicked in different views and take X-Rays of teeth. Impressions of teeth might have to be taken to prepare the diagnostic casts for pre-treatment evaluation. In this appointment, you should also tell your dentist what changes you desire in the shape and colour of your teeth to improve your esthetics. Dentist will explain you to what extent these changes are possible. Dentist may make the desired changes possible in the dental casts to show you beforehand appearance of teeth after treatment. Some dentists have computer imaging systems to show the actual images of your smile before and after the treatment.

There are two techniques for veneer placement:

  1. Direct Technique: In this technique tooth veneer placement is completed in singleappointment using composite material. It can be used only when defect is very small and small amount of tooth structure requires to be covered by a veneer. In thistechnique small amount of enamel is removed from the area of defect, tooth surface is etched using 37% phosphoric acid and composite material is bonded on the etched tooth surface.
  2.  Indirect Technique: In this technique, usually two appointments are required for placement of a tooth veneer with a time interval of 2-3 weeks in between.

 In the 1st Appointment:

Tooth to be covered by a veneer, is reduced to the thickness of veneer/laminate so that size of tooth does not change after the placement of veneer. Usually 0.5-0.7mm of the tooth reduction is required for veneer placement. If more than one tooth require to be covered by a veneer, all the teeth can be reduced on the same appointment. If patient experiences pain due to sensitivity while tooth cutting, local anesthesia can be given to numb the tooth.

 

Then impression of the tooth is taken and sent to dental lab for fabrication of a veneer. CAD/CAM technique can be used for veneer fabrication if facility is available with the dentist. In this technique dentist takes optical impression of the tooth using a camera and image is fed in the computer. After processing the image information is fed in the milling machine which fabricates veneer from a ceramic block.

 

After tooth reduction, tooth surface becomes relatively rough which causes repeated contact of tongue with the tooth and sometimes sensitivity to hot and cold foods occurs and to overcome this problem tooth is covered by a temporary veneer. But it is not always necessary to cover the tooth with a temporary veneer because very small amount of tooth reduction is done to place a veneer.

On the second appointment:

1.  Firstly the tooth veneer is evaluated for accurate fit and proper color matching with the neighboring teeth. If veneer is not fitting properly dentist may grind it repeatedly in small amounts until a proper fit is achieved. To achieve optimum color matching, shade of the cement to be used to bond the veneer can be selected accordingly. According to selected shade trial paste of cement is used to confirm the shade of cement. If it doesn’t match other shade can be selected until a proper colour matching is achieved. 

2.  Tooth Veneer is evaluated for overall shape. It should enhance the esthetic appearance of the tooth. Tooth Veneer is fabricated slightly oversized so that its shape can be modified afterwards as per requirement.

3.  Then the veneer is bonded on the tooth. Before bonding the veneer, the surface of tooth as well as veneer is cleaned, the tooth surface is etched which creates surface roughness for appropriate bonding of veneer with the tooth.

4.  Tooth veneer is filled with the resin cement and is placed on proper position over the tooth. After ensuring its correct position, it is cured using light cure gun.

5.  The excess cement on the sides of veneer is trimmed off and veneer is polished.

6. If any discrepancy is present in desired shape, it is corrected after cementation.

 Post Cementation Appointment

Tooth veneer is evaluated after about a week to observe that how gums have responded to the presence of veneer. And if patient requires any modification in shape that can also be done in this appointment.

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