When to break proximal contacts with porcelain veneer preps?

The 3 most common porcelain veneer preparation designs are: 

minimal prep, traditional veneer prep, or slice through contact prep for Porcelain Veneers.    

We get asked the most about the interproximal area of the preps for veneers.  

If you are not breaking contacts, you need to determine how and where you want the interproximal margins.  I generally think halfway from buccal to lingual through the contact area can work well.  

When prepping the interproximal you do not want to create undercuts otherwise seating the veneers will be more difficult.  

If you do a slice prep and break the proximal contacts, make sure you maintain good draw and taper and parallelism to help with the seating of the final veneers. 

3 Most Common Types of Veneer Preparation Designs

  1. Minimal Preparation Porcelain Veneer 

When prepping you correct minor arch form issues.  WIth this Preparation you do not open the proximal contacts while prepping.  There are thin finish lines and margins.  Best for cases where you plan to be adding volume to the incisal edges and to the facial thickness.  Mostly used when the Veneers are additive to add volume.

  1. Traditional Porcelain Veneer Preparation

Requires Adequate reduction on the Facial and incisal.  This type of Veneer Preparation you do not break or opening proximal contacts

  1. Slice Preparation for Porcelain Veneers

This is when you slice through the proximal contacts or open the proximal contacts. Recommended for cases where you have the following: Overlapped teeth, interproximal decay, interproximal fillings, closing diastemas, black triangle closure, or moving tooth positions.   

Reference for when to open contacts when prepping for porcelain veneers

  • Large gaps between the teeth
  • Black triangle spaces at the gumline between teeth
  • Crowded teeth
  • Crooked teeth
  • Fillings between teeth
  • Cavities between the teeth
  • Spaces between the teeth
  • Midline discrepancy
  • Changing the widths of the teeth
  • Moving tooth positions mesially or distally

If you’re wanting to learn more about smile design, veneers, and cosmetic dentistry, check out our online aesthetic dentistry and smile makeover courses at https://drtejaspatel.podia.com

Veneer Masterclass Summary of Cases

The Veneer Masterclass shows you how 3 smile makeovers were completed from start to finish to help give you the confidence to do more veneer cases.  

Case #1 

Learn how to use porcelain veneers to improve the size, shape, & color of the teeth and how to improve the midline, cant and fullness of a smile.  

Case #2 

Learn how to use porcelain veneers to improve the size, color, and symmetry of the teeth and how to improve a gummy smile with laser gum contouring. 

Case #3

Learn how to use porcelain veneers to improve the size, color and alignment of the teeth to get a more symmetrical, straighter, whiter, and fuller smile. 

If you’re wanting to learn how to do veneers, do more cosmetic dentistry, smile makeovers and grow your practice, enroll in our online veneer course for dentists at https://drtejaspatel.podia.com

Veneer Masterclass by Dr. Tejas Patel

Here’s a list of everything you need to know about the Veneer Masterclass. This Masterclass is the comprehensive course that will help you take your cosmetic dentistry skills and your porcelain veneer cases to the next level.  

What you will learn in the Veneer Masterclass…

  • Treatment Planning
  • Consultation and Design
  • Case Presentation
  • Case Selection
  • Smile Design
  • Porcelain Veneer Workflow
  • Wax Up Design and Review
  • Veneer Preparation Design
  • Veneer Preparation Techniques
  • Minimal Preparation Veneers Technique
  • Veneer Preparation Sequence
  • Making Temporary Veneers
  • Shrink Wrap Temporary Veneers Technique
  • Lab Communication
  • Porcelain Veneer Bonding Protocol
  • Porcelain Veneer Cementation
  • Placement of Porcelain Veneers
  • Occlusion for Veneer Cases
  • Complications 
  • Troubleshooting
  • Recommended Labs
  • Recommended Materials
  • Recommended Equipment

What you get in the Veneer Masterclass…

  • Over 4 Hours of Online Video Training
  • In-Depth Videos of the Entire Porcelain Veneer Process
  • Dr. Patel’s explanation of Each Step
  • Comprehensive Review of Porcelain Veneers
  • Watch 3 different 10 unit Porcelain Veneer Smile Makeovers in real-time
  • Learn How to do Porcelain Veneers and Smile Makeovers
  • Veneer Guide for Dentist & Social Media Marketing for Dentists E-Books included
  • Private Podia Group Access to ask Dr. Patel questions 
  • Top-Rated Online Veneer Course for Cosmetic Dentists
  • Lifetime Access to Course

The goals of this course are to help you:

  • Do more veneer cases
  • Grow as a cosmetic dentist
  • Grow your practice
  • Increase your profitability
  • Reduce your stress 
  • Follow a solid workflow
  • Get consistent results
  • Build your confidence in doing veneer cases

DON’T GET LEFT BEHIND…

As you can see this course is jam-packed!  Top Cosmetic Dentist, Dr. Tejas Patel has distilled years of practical and clinical knowledge into a few hours.  

If you do just one veneer case after taking this course, it will have more than paid for itself. 

Plus, right now the public demand and expectations for veneers is at an all time high. 

Now is the time to learn how to get consistent results with your veneer cases and improve the cosmetic dental care that you provide to your patients. 
If you’re wanting to learn how to do veneers, do more cosmetic dentistry, and grow your practice, check out our online veneer masterclass and smile makeover courses at https://drtejaspatel.podia.com

Cosmetic Dentistry: Top 10 Treatment Options to Improve a Smile

There are many ways dentists can improve a smile with cosmetic dentistry treatments.  Here are 10 of the most common treatment options when considering how to improve a smile. 

  • Teeth whitening
  • Teeth straightening
  • Teeth Contouring
  • Dental bonding
  • Gum Contouring
  • Composite veneers
  • Porcelain veneers
  • Porcelain crowns
  • Porcelain bridges
  • Dental implants

Everyone is different, and there is a different solution for each person. Sometimes, the solution that is best for your patient may be a combination of the treatments listed above. Always help your patients make an informed decision by explaining each of their options.  As their cosmetic dentist, make sure that you understand all of the options available. 
If you’re wanting to learn more about case presentation, treatment planning and patient communication, check out our online cosmetic dentistry and online veneer courses for dentists at https://drtejaspatel.podia.com

10 smile design principles for successful smile makeovers.

Designing a smile that your patient is happy with is one of the main goals of cosmetic dentistry.  Being able to meet and exceed their expectations is key.  

Take the time to plan your smile makeover cases.  Get wax-ups done to help prepare for your cases and to design beautiful temporaries for you and your patient to review.  

Here are my top 10 things that I take into consideration when designing a smile makeover using porcelain veneers.  

SMILE DESIGN PRINCIPLES

  1. Review of patient goals
  2. Size of Centrals
  3. Gum levels
  4. Desired Shape of Teeth
  5. Color (desired vs. initial, and  prep shades, cement shade, final shade)
  6. Fullness of the smile
  7. Straightness/ Spacing/ Arch Form Issues to Correct
  8. Midline
  9. Cant
  10. Bite/ Occlusion/ Function

If you’re wanting to learn more about smile design, veneers, and cosmetic dentistry, check out our online aesthetic dentistry and smile makeover courses at https://drtejaspatel.podia.com

Case study #3: Managing discoloration, prior restorations, narrow smile, and overlapped teeth for an 8 unit smile makeover porcelain veneers case

Our patient presented crooked and overlapped front teeth and decalcification and discoloration and stain on their teeth. Patient tried whitening and and was unhappy with their smile and wanted a brighter, more symmetrical and better smile.

Treatment plan

  • Upper 8 teeth porcelain veneers
  • Upper teeth laser gum contouring as needed
  • Lower teeth whitening
  • Lower teeth enameloplasty/ contouring

Special considerations

With the discoloration making sure to be able to block out the prep shade so the veneers have to be prepped and designed sufficiently to ensure longevity and success.

Steps for success

  • Waxup from lab along with inspiration pictures to ensure we can meet patients expectations
  • Work out any issues in the temporary veneers.
  • Take time to establish the size, teeth shape and color of the newly designed smile.

Procedure learning points

At her post op after the veneer’s cementation, the canines were uneven and too long. I shortened and reduced the incisal edges/ cusp tips of the canines to make the smile look less like a reverse smile. I had to adjust the porcelain to make the smile more symmetrical.

Teeth were minimally prepared for porcelain veneers but I should have made #9 a full coverage to facilitate the design and seating of the restorations or opened the mesial proximal contact area more.

With the discoloration we used a brighter shade for the veneer cement to block out the undertone of the prep shade. 

Porcelain Veneers Details

We did Emax porcelain veneers shade HTBL1 with a bleach shade calibra veneer cement.

If you’re interested in learning how to do more porcelain veneer cases, check out our online cosmetic dentistry courses and resources at https://drtejaspatel.podia.com/

Case #3 images.

Close up Retracted photos were taken immediately after seating the restorations.  Gums will heal. 

Case study #2 : Managing wear, asymmetrical teeth, narrow smile and gums for top 10 porcelain veneers

Patient presented with prior Orthodontic treatment and whitening and was still unhappy with their smile and wanted a brighter, more symmetrical, broader, fuller and less gummy smile.

Treatment plan

  • Upper 10 teeth porcelain veneers
  • Upper teeth laser gum contouring
  • Lower teeth whitening
  • Lower teeth enameloplasty/ contouring

Special considerations

With the history of wear making sure the veneers are prepped and designed sufficiently to ensure longevity and success. Also needed to create a more level smile and improve the cant of the smile and gumline.  

Steps for success

  • Waxup from lab along with inspiration pictures to ensure we can meet patients expectations
  • Work out any issues in the temporary veneers.
  • Take time to establish the size, shape and color of the newly designed smile.

Procedure learning points

Patient felt the temps were a bit too long. She was used to the original size of her teeth. We discussed tooth proportions.

Patient preferred more pointy canines than what she saw in temps.

Teeth were minimally prepared for porcelain veneers but I should have opened the proximal contact between the centrals to close the black triangle or gap at the gingival embrassure.

I may go back and add composite from the lingual to close that space more or even redo the 2 centrals.

Porcelain Veneers Details

We did Emax porcelain veneers shade HTBL1 with a bleach shade calibra veneer cement.

If you’re interested in learning how to do more porcelain veneer cases, check out our online cosmetic dentistry courses and resources at https://drtejaspatel.podia.com/

Case #2 images. 

Case study # 1: Managing the color and occlusion for 10 upper and 10 lower porcelain veneers full smile makeover.

Patient presented with prior Invisalign treatment and whitening and was still unhappy with their smile and wanted the brightest and most perfect smile.

Treatment plan

  • Upper 10 teeth porcelain veneers
  • Lowers 10 teeth porcelain veneers
  • Special considerations / challenges
  • Lower anterior crowding. Almost class 3 occlusion and anterior crossbite on upper laterals.

Steps for success

  • Waxup from lab along with inspirational pictures to ensure we can meet patients expectations.
  • Make sure to have enough facial reduction on areas that are crowded and positioned more facially.
  • Make sure the patient has good posterior stops for occlusion and bite registrations during the process.
  • Having a good workflow to keep the patient comfortable during the procedure.

Procedure learning points

Patient loved the temps and the design. Having a great waxup and her approval for the temps was key.

Getting the right color and shade was the challenge.  

At first the patient opted for a shade that wasn’t bright enough and after removing temps and trying in with try in paste we sent to case back for a brighter shade LT BL1

When a patient is particular make sure to do a try in with try in paste and show them the veneers and get their approval before cementing them on.  We take videos and photos of the try in to show the patient as well as have them look in a mirror to get their approval.  

After this we created an album with various smile design colors to show patients.  Final shade is sometimes hard to communicate.  The plastic shade tab versus the final outcome shade can vary.  The final shade of the case depends on the: prep shade, thickness of porcelain, cement shade, and shade of the porcelain as well as the translucency of the porcelain.  

Porcelain Veneers Details

We did Emax porcelain veneers shade LTBL1 with a bleach shade calibra veneer cement.

If you’re interested in learning how to do more porcelain veneer cases, check out our online cosmetic dentistry courses and resources at https://drtejaspatel.podia.com/

Case #1 images. Close up Retracted photos were taken immediately after seating the restorations.  Gums will heal.

Reduction guides for Porcelain Veneers Preparation

Almost every porcelain veneer case we use a reduction guide.  I generally have an incisal reduction guide and a facial reduction guide.  Especially for minimal prep veneer cases, this is essential.  The reduction guides are based off and made from a diagnostic wax up from our laboratory.  We use Reliance Dental Lab and Williams Dental Lab (both located in California), routinely for our waxups.  The reduction guides help to ensure that there will be adequate thickness of porcelain as your final restoration.

As you can see in the photos, we try to ensure a uniform thickness or equal space or reduction for each tooth for the future final restoration.  
If you’re interested in learning more about our smile makeover courses visit https://drtejaspatel.podia.com

Free Training WebinarAvoid These 4 Mistakes and Do More Veneers

In this free training webinar, top cosmetic dentist, Dr. Tejas Patel discusses the 4 biggest mistakes dentists make when doing veneers. He also discusses how to avoid these mistakes so you can do more veneers.