Clinical Continued »


cervical area and provides the dental technician with important information, while the lateral view provides important information about the lip support and phonetics (Fig 4). The images on the screen


were discussed with the patient, and it was clarified that it would not be possible to harmonise the width of the incisors using non-prep veneers because this would require tooth reduction, a process the patient declined. She was consequently aware that tooth 2ı would remain wider than tooth ıı after the treatment.


Wax-up and try-in veneers Based on the wax-ups, which were prepared to a high aesthetic level (master model, aesthetic wax with different colours, anatomically ideal position and pronounced features adjusted to the wishes of the patient) and shown to the patient, the try-in veneers were prepared in shade Aı (Anaxdent, Germany) (Fig 8) and adhered to the teeth with the try-in paste of the luting composite (Vitique, DMG). This facilitates optimal patient communication, and the try-in veneers could now be “reviewed” live and in full colour in the mouth so that both the patient and dentist could agree on the proposed treatment. The patient was prompted


to make “S” sounds to ensure that the phonetics were not negatively impacted. After any adjustment, if necessary, the try-in veneers should be shown to the patient. This should be documented photographically (lip at rest, mouth slightly opened, smiling, laughing) and attached to the records. An impression was taken of


the situation (Fig 6) and this formed the clear and definite specification to enable the dental technician to prepare the veneers with “zero tolerance” regarding tooth length and shape. The standard procedure for patients who receive veneer


restorations is bleaching at least one week before attachment to ensure a base that is as light as possible to provide the best shade for the ceramic.


Veneer preparation Aesthetic non-prep veneers in the anterior region place high demands on both dental technicians and materials. In our collaboration with Shahab Esfarjani, a master dental technician who is a disciple of the Swiss Oral Design School of Willi Geller, coating a platinum foil with feldspar ceramic has become a proven technique. Along with the aesthetics, it


must be mentioned that, from a materials science perspective, the platinum foil does not store any heat and therefore does not have a negative effect on the ceramic. To achieve optimal aesthetic


results, Shahab brought his equipment into the practice to prepare the veneer live and on-site. This guarantees optimal adjustment of the shade and brightness (value) to the adjacent teeth in agreement with the patient, who generally place high demands on aesthetic restorations (Fig 7). The ceramic GC Initial MC


(GC Germany) was used and was constructed on refractory dies (Cosmotech Vest, GC Germany).


Placement of the veneers Cementation is critical for the success of a non-prep veneer restoration. Even if the technician does brilliant work, if the dentist makes an error during the adhesive luting, the success will only be short lived. Staining, marginal gaps, fractures or veneers that repeatedly fall off can occasionally lead to considerable alienation between patients and dentists. In our practice, we choose


to use Vitique from DMG as our standard adhesive luting composite. It provides the option of guaranteeing the shade for adequate luting of the veneer by using try-in


Continued »


Fig 4


Side view of the try-in veneers during phonetic testing by the patient (“S” sound)


Fig 5


Frontal view of the try-in veneers


Polyether impression of the try-in veneers Fig 6


Shahab Esfarjani during the live construction in our practice Fig 7


Non-prep veneers before placement Fig 8


Ireland’s Dental magazine 37


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