Diastema closure, Filling gaps between teeth, Reverse smile line
This Highland Park, IL patient was concerned that she showed too much gum on the sides of her smile and her front teeth were too short and too small for her face. When the front teeth are shorter than the side teeth, it is called a "reverse smile line". She was tired of having her old dentist replace the bonding that filled the gaps between her teeth every 5 years and wanted her teeth to look better. She was a nighttime tooth clencher-grinder and the composite bonding chipped frequently. Her dentist was worried that if he placed veneers, they would break off due to the bruxism.
Making the "smile line" follow the contour of the lower lip, natural optical qualities of feldspathic porcelain
The patient had bilateral "gum lifts", also called crown lengthening, to reduce the amount of tissue showing in her smile from side views and 6 "feldspathic porcelain veneers". Feldspathic porcelain has the optical characteristics that most closely match natural teeth. The veneers were used to fill the gaps between the teeth and to give her a more appealing smile line. Porcelain veneers are an ideal restorative option to fill gaps or spaces between the teeth. Many dentists will drill too much tooth structure away when they prepare teeth for veneers. When your dentist is conservative with the tooth preparation and leaves the majority of enamel in place, the veneer bond is extremely high and the tooth is actually strengthened by the new veneer. This makes these restorations perfect for night grinders.
Understanding Feldspathic Veneers
Creating veneers using feldspathic porcelain is a master craft method that few dentist/technician teams employ. This method employs a laborious hand stacking technique layering small amounts of different porcelains. These porcelains vary in levels of opaqueness, brightness, and color, and are artfully laid down as the tooth form is built up. Usually less drilling on the teeth is needed because these layered porcelains match the existing tooth shades better than pressed coping veneers. The custom craftsmanship process of building feldspathic restorations yields a vibrant appearance that creates the most natural and life-like result for patients. This type of veneer is desired due to unmatched blending capabilities as well as aesthetics. This ceramic choice that is the least likely to ever have a black line at the gumline. Dr. James Fondriest offers these types of restorations at Lake Forest Dental Arts in Chicago, IL.
When is Feldspathic Porcelain Recommended?
Feldspathic porcelain is considered one of the most appealing cosmetic solutions. This veneering fabrication style may be recommended for patients with teeth that are:
- When the patient does not grind their teeth
Feldspathic porcelain restorations have been losing market share in the United States. It is not because this hand crafted type of veneer is of less quality or that it does not last as long. In the rapidly evolving world of cosmetic dentistry, the market for feldspathic porcelain veneers would disappear instantly if that were true. This type of porcelain system takes longer to make and requires more training on both the lab and dentist sides. They are usually more costly to produce and are more technique sensitive for the dentist to deliver. Creating and providing feldspathic ceramic versions is an art that is mainly left for the high end market.
Benefits of Feldspathic Porcelain Veneers
As an alternative to other types of veneers, feldspathic porcelain veneers offer various benefits. Those benefits include:
- Improving the shape or position of teeth
- Perfecting the color of teeth
- Hiding surface color deficiencies
Are feldspathic veneers strong?
It depends on your dentist and how much tooth is left. When your dentist is conservative with tooth preparation and leaves the majority of enamel in place, the feldspathic porcelain bond is extremely high and the tooth is actually strengthened by the presence of the new veneer. The feldspathic restoration is considered monolithic with one type of porcelain. It does not have a strong coping substructure to support it. The tensile strength of 85 MPa is low on its own and needs to be treated like fine china until it is bonded onto the tooth. This type of restoration gains its strength from the bond to enamel. If supported and bonded to enamel, it is incredibly strong. Many, if not the majority of dentists will drill too much tooth structure away when they prepare teeth for veneers. If much of the enamel is lost during preparation, and less than 50% of the remaining exposed clinical crown has enamel to bond to, then the feldspathic porcelain restoration will be one of the weakest restorative options and is contraindicated for patients who are tough on their teeth. Understandably, the choice of restorative material is often made intra-operatively.
Monolithic versus Bi-layered porcelains
There are two basic porcelain restoration designs. Monolithic means that the entire restoration is made of one type of porcelain. Bi-layered restorations have two layers, a stronger coping layer closer to the tooth and a veneering porcelain layer baked on top of the coping. Studies on ceramic failures show that when monolithic restorations chip or break, it usually occurs as an “adhesive failure”, meaning that the bond breaks between the tooth and the porcelain. A bi-layered crown or veneer will usually fail due to a “cohesive failure” which is fracture between the two main layers. The cohesive failure is due to differing tensile strengths and coefficients of expansion. The strongest two monolithic porcelains available in the existing dental market are E Max monolithic and Zirconium monolithic.
A feldspathic veneer is considered monolithic or one layered. Monolithic restorations can be stronger than bi-layered porcelain when bonded on supporting enamel. They tend to be weaker when the teeth have been drilled down and no enamel remains. This requires that they be bonded to to dentin.
If any type of cosmetic dentistry is requested, the more qualified cosmetic dentist or prosthodontist will do a dento-facial analysis. This analysis is an assessment of how the face and lip symmetry affect how the teeth display in a smile. The lips are said to be the picture frame for the teeth. It is customary for the dentist to take a series of photographs documenting the smile at many angles as well as how the gum tissue is shaped. Measurements are then taken on major landmarks on these images and compared with prevailing norms. If any ratios vary “significantly” from the norm, then the patient is offered the customary and usual treatment protocol to fix the problem. It is the patient’s right, privilege, and responsibility to make the final decisions on what treatment offerings are done based on the individual’s vision of importance.
Contact Lake Forest Dental Arts
The custom craftsmanship process of building feldspathic restorations yields a vibrant and vital appearance to the veneers that can create the most natural and life-like smile makeovers that can be achieved. If you would like to learn more about with feldspathic porcelain veneers at our Chicago, IL practice, schedule a consultation with Dr. Fondriest by calling 847-234-0517. We look forward to talking with you about feldspathic porcelain veneers, and providing you with quality and personalized service.
Dr Fondriest is a Nationally recognized and highly sought after cosmetic dentist serving clients from throughout the United States