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.

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Replacement of Old Veneers

Advance Your Practice Toward Great Dentistry

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