A Visual Essay – Replacement of Old Veneers

Replacement of Old Veneers

Replacement of existing ceramic veneers is a common procedure in a restorative practice. It not only involves removing old material and replacing it with new material, but also a thorough dentofacial assessment in which we must check:

Color
Contour
Arrangement
Position

This visual essay will walk the reader through the basic steps of replacing ceramic veneers:

Facial pictures showing tooth display in repose and full smile. — Figure 1: Facial pictures, depicting tooth display in repose and full smile.

Facial pictures demonstrating using retractors to assess incisal /occlusal plane orientation. — Figure 2: Utilizing retractors is the best way to assess incisal/occlusal plane orientation.

Frontal pictures in occlusion and separating the teeth to further show the incisal plane discrepancy. — Figure 3: Frontal pictures in occlusion and separating the teeth show the incisal plane discrepancy, and it needs to be captured accurately in the photograph.

Lateral views of old ceramic veneers. — Figure 4: Lateral views of the old ceramic veneers.

Mounted casts and wax-up. — Figure 5: Mounted casts and wax-up in order to correct contour and incisal plane orientation.

The old veneers are removed without damage to the tooth structure and the teeth are lightly re-prepared. — Figure 6: Utilizing Waterlase iPlus (Er,Cr:YSGG), the old veneers are removed without damage to the tooth structure and the teeth are lightly re-prepared.

Figure 7: Retraction cord is placed before impressions are made.

Utilizing reduction guides to verify adequate tooth reduction based on the wax-up. — Figure 8: Reduction guides are utilized to verify adequate tooth reduction based on the wax-up.

Figure 9: Frontal view of provisional restorations.

Figure 10: Provisional restorations in place.

Figure 11: Extraoral evaluation of the provisional restorations.

Figure 12: Feldspathic ceramic layering.

Figure 13: Finalized ceramic veneers on master cast.

Figure 14: Finalized feldspathic ceramic veneers.

Figure 15: Try on of the ceramic veneers.

Figure 16: Ceramic veneers after cementation.

Figure 17: Full smile with ceramic restorations.

Figure 18: Two-week post-bonding evaluation.

Figure 20: Facial integration of the definitive restorations.

A step-by-step technique for replacing old veneers utilizing a laser unit to remove pre-existing restorations allows for a fast, clean removal with minimal tooth reduction. The replacement with feldspathic veneers is a very common procedure in practice, in which a careful dentofacial assessment of the orientation of the incisal/ occlusal plane is essential to ensure optimal esthetics of the new restorations.

Ricardo Mitrani, D.D.S., M.S.D., is a member of Spear Resident Faculty.

Comments

Tom Z.
December 8th, 2020

Beautiful work. Do you ever recommend any sort of finishing of the margins of the veneers along the gingival margin?

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Replacement of Old Veneers

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