When prepping teeth for veneers. I use the following sequence:
Gross reduction
- Arch form
- Facial
- Incisal
Finishing
- Verify Draw
- Interproximal Preparation
- Clean margins
- Soften Corners
Gross Reduction
Arch form correction
Prep the facials or linguals of the teeth that are out of the newly designed and ideal arch. I use a straight or chamfer bur to accomplish this.
After this is complete, you should be working with fairly straighter teeth and a more uniform arch.
Facial Reduction
Next I like to complete the facial reduction. There are many different reduction guides you can use. I like the 0.5mm reduction bur with 2 to 3 depth guards on it.
After this is complete, I use a thin chamfer diamond bur to complete the facial reduction and wipe away the depth markings.
Incisal Reduction
Oftentimes, when doing the facial reduction, you unintentionally begin to reduce the incisal edges as the facial surface gets thinner.
I will use the verification jig we have to verify the incisal reduction before I begin this step. I may even set the handpiece to a slower setting or use a less aggressive bur. I do like the donut/ flat shaped bur to help get a straight line incisal edge reduction.
Finishing
Verify Draw
Things can look different from your view versus your assistant’s view. Also, when you look from directly over the patient, the view and perspective changes.
Once my gross reduction is done, I then stand up and lean over the patient to get a direct frontal straight view of the preps. I want to make sure no facial surfaces are sticking out and I want to make sure my preps look parallel to the desired midline.
Take time here because it will help make your seats go easier.
Interproximal Preparation
Either you have a minimal prep, traditional veneer prep, slice through contact prep, or crown prep.
We get asked the most about interproximal preps.
If you are not breaking contacts, you need to determine how and where you want the interproximal margins. I generally think halfway or less through the contact area can work well. When prepping the interproximals you do not want to create undercuts otherwise seating the veneers will be more difficult. I usually have the bur tip slightly angled facially to help with the draw of the final veneer.
If you do a slice prep and break the contacts, make sure you maintain good draw and taper and parallelism to help with the seating of the final veneers.
Clean Margins
Now that the majority of the prep is complete, I’ll refine and define all the margins that I have created. This can be done at a slower speed or with a less aggressive bur. I’ll want to make sure to tuck my facial margin slightly below the gumline (just the tip of the bur) to create a good emergence profile for the veneers.
Soften Corners
The last step of the prep sequence is to make sure there are no sharp corners or angles that need to be softened so as to not weaken the future veneer. I take a needle nose bur at a slower speed or an enhanced cup to achieve this.
If you’re wanting to learn more about how to do veneers, the step by step veneer process, veneer preparations, and cosmetic dentistry CE courses, , check out our online Veneer Masterclass and smile makeover resources at https://drtejaspatel.podia.com
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