Clinical To prep O


ne of the hottest topics in dentistry today is that of ‘No Prep’ veneers. The interest in this


technique is obviously consumer driven and the increased interest by clinicians is a direct result of their patients asking about it. This interest is due to the fact that a major dental manufacturer went to the consumer and said: “You’ve got to have these”. Now the consumer, having read or seen marketing propaganda, comes to our office asking about treatment. The whole concept of prepless or minimal prep veneers has been around for many years, but it has not been until recently that we have seen such widespread interest among clinicians. Many clinicians placing veneers today were taught that they must do relatively aggressive preparation to yield acceptable aesthetic results and so the ability to place aesthetic veneers without preparation is a relatively new concept for most clinicians, yet one that they must be familiar with.


or not to prep


Are non-prep veneers an option for the demanding dentist and their patients? By David S. Hornbrook, DDS, FAACD


This will be a huge paradigm shift


for so many clinicians, like myself, that always had the mindset that if you are going to add something on the facial of the tooth, then you must remove something to make the room. Like many clinicians, there was a pool of patients that I had either declined treatment because they would not let me prep their teeth, or that didn’t approach me because they were concerned about getting their teeth prepped. As I began looking more closely at this technique, I struggled with the fact that the non- prep veneer cases that I had seen – prior to really understanding how to make this work – all looked bulky, ugly and too opaque. I did not think that they were representative of the type of artistic dentistry that I wanted to provide. I realise now that those cases were a direct reflection of the lack of pre-planning and designing the smile, incorrect use of materials, and the quality of the ceramists used, not because they were necessarily minimal preparation. I think as dentists practising in this


“Success is reliant on educating your ceramist to get involved in utilising the materials to do prepless or minimal prep


veneers” David Hornbrook


new millennium, we need to look very closely at technique and concept of the prepless or minimal prep veneer and decide if this is something we can offer our patients that will provide a good aesthetic result coupled with a long-term prognosis. It’s important for the clinician to realise that there’s not just one certain brand of ceramic, or one certain manufacturer, or one laboratory that can do your prepless veneers. The prepless or minimal prep veneer is a technique, not a specific product. Any ceramic can be used and most great ceramists can give you great results. Success is reliant on educating


your ceramist to get involved in utilising the materials to do prepless or minimal prep veneers, and also the communication process in case selection and diagnosis. Many clinicians I have spoken with spend a lot of time in the smile design process and write a very detailed lab prescription when the treatment is a prepped veneer case; yet spend very


Continued »


Fig 1 Patient 1 before


Fig 2 Patient 1 after


Fig 3 Patient 2 before


26 Ireland’s Dental magazine


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44