No prep or minimally prepared Porcelain Veneers

Not every smile is a candidate for no prep or minimally prepared veneers. We as astute clinicians must understand the techniques, advantages and limitations.

The ideal no-prep veneer or ultraconservative prep veneers falls under two or three categories:-

1. Patients with short worn-down teeth in which teeth abrade and tend to lose their sharp labial contours and anatomy. When we add a little bit of labial contour in the right dimension and right contour to create a more ideal appearance.

2. Patient treated with biscuspid extraction orthodontics as their teeth are lingualized to the point where we restore them cosmetically.

3. When one or two teeth are slightly out of alignment or ditched in the teeth in anterior region.

Many individuals seeking smile enhancement do not desire treatment that requires removal of healthy tooth structure.

Patients get most excited about pure prep-less restorations that are truly reversible.

Now in a truly prep-less case, we literally don’t touch the tooth with the bur whereas with very minimal and super ultra conservative preparation, we still use a bur.

For example, if we place a tiny margin at the tissue line,it requires almost no invasiveness. We also round the facial incisal line angle as that could create a stress  point and fracture so rounding a sharp facial incisal line angle technically is not a prep-less case anymore.

In cases like this, patients may have to be guided into accepting some minimally invasive technique that may be required. If we put a margin at the gum line that would drive it away from the pure prep-less concept but it is still in the same family.

So rounding a corner or an edge does not make the case irreversible so “Reversible” is really a keyword to include in our communication.

CONTRAINDICATIONS:-

1.      Dark colored teeth as we have to develop a masking system which cannot be done with thin veneers.

2.    Labially positioned tooth or a bold tooth.                                                     

So, we cannot replace those cases where more aggressive things have to be done and there is always going to be a need to reduce the teeth and remove unsightly things.

“I strongly believe that we are going to see a generalized swing of the pendulum over the more conservative dentistry.”

Dr. SWEEN KATHURIA, COSMETIC DENTIST & ENDODONTIST, sweenkathuria@gmail.com South Delhi