"Minimal preparation dental veneers" - Limiting tooth reduction - Less drilling
This Highland Park patient complained of an uneven gummy smile and unattractive teeth with diastemas (spaces between the teeth) and old chipped composite bonding. Large amounts of composite filling material had previously been used to artifically reshape her teeth. The bonding had always made her teeth feel thick and it continued to chip. This lady wanted to replace the old plastic filling material but did not want any of her natural tooth enamel to be removed. Dr. Fondriest removed all of the old artificial material and covered her front six teeth with Empress porcelain restorations.
Preserving tooth structure with less tooth preparation or drilling
The patient had a special gum surgery to raise the gums up to the lower border of the upper lip (this procedure is called a gum lift, crown lengthening, or perioplastic surgery) and to make the scallop symmetry even. Then "Empress porcelain veneers" were done by only removing the old bonding material. Only a very modest amount of tooth preparation was done to remove some dark stains on the natural teeth. Patients appreciate it when the dentist saves as much of the tooth structure as possible. The process of making veneers with very little or no tooth preparation is called doing "Prepless Veneers".
There are alot of very good reasons to limit tooth reduction. With less drilling, appointments can be shorter. Novacaine is used sparingly or is not needed. Temporary veneers are time consuming and difficult to make attractive. These temporaries may not even be needed when no or little tooth structure is removed. The impressions are less difficult and often less invasive. It is easy to understand that the more tooth structure, the stronger the remaining tooth. Especially when doing veneers for elective reasons, limiting tooth removal is preferable. With more enamel, the strength of the bond of the veneer to the tooth is stronger and the margins have a more durable seal.
The high technical difficulty of “prep-less veneer” or “low-preparation veneer” designs
It is only a small minority of cases where high quality can be achieved with absolutely no preparation. Yes there is alot of marketing hype that suggests otherwise, but remember that overall quality is measured by esthetics, cleansability, and longevity. To achieve overall success, some modest and subtle reduction is usually necessary. While it is easier and faster for the dentist to make crowns and veneers with a gross or heavy reduction, great care is needed to create a “line-of-draw” for the prep-less restoration to be placed and still cover all visible portions of the tooth from all visual directions. It is a common occurence for a poorly trained practitioner to leave large “over-hangs” (porcelain that does not have a good fit or it’s emergence profile causes floss to shred or catch) while attempting to provide full coverage of visible parts. These overhangs lead to difficult or impossible cleaning. If you can’t clean regularly, recurrent decay, stains, or gum problems will develop.