Veneer Replacement Old Discolored Aged Yellowed Dull Veneers Repair New White Porcelain Bonding Boca Raton Dentistry




Dr. Mitchell Pohl 2900 N. Military Trail Suite 105 Boca Raton 33431 South Florida Dentistry (561) 368-3440	Replacing Porcelain Veneers - Boca Raton This attractive middle age female patient consulted with us regarding her existing veneers. She was very unhappy with the appearance of her old veneers and felt that as a successful independent business woman and company President, a more attractive smile was imperative for her professional and social activities. Her veneers had only been placed about ten years ago on her top four anterior (front) teeth and were made to match the color of her lower anterior teeth. Unfortunately, her lower anterior teeth were a moderately yellow brown color, which on a Vita Shade Guide would be about an "A 3.5". Outdated Veneer Technology The old veneers were very monochromatic and dull. Dull veneers can be polished somewhat, but not to the same gloss as is achieved when fired in an oven. Other obvious aesthetic factors were the shape and proportion of the veneers to each other and to the existing teeth. There was also a missing second bicuspid on the left side which over time had caused a shifting of her teeth. Due to improper preparation one can also see the cement line and proximal margin on the left lateral incisor. Low Prep (Preparation) versus No Prep Veneering It is important when preparing a tooth for a veneer, that enough tooth structure is removed between the teeth so that the margin of the veneer is not seen but more importantly, the color of the existing tooth is not visible. Of course there are other considerations to take into account, especially when deciding on what type of veneer to place, i.e. a no-prep veneer (Cerinate Lumineer) or a prep veneer (DaVinci veneer). Visit our Lumineer page for more discussion on minimally invasive dentistry. In this instance for this particular patient it was important to prepare her teeth to achieve the most esthetic outcome. Her current veneers had involved different degrees of tooth preparation... therefore they would be replaced with prep veneer products. Veneer Cements The type of cement used is also an important factor. The most common type of cement used for veneers is a resin cement. Unknown to most dental patients, resin cements come in different shades. In our office we typically use transparent cements. A transparent resin cement allows the porcelain margin of the veneer to blend well with the tooth structure thereby producing an indistinguishable lamination. Tinted Cement and High Translucence In other situations where color characteristics of existing teeth require an added degree of porcelain art, we combine special high translucency veneers with uniquely colored dental cements to produce the cosmetic result desired by the patient. The plan for this patient was to replace the old veneers, veneer her two canines and place three all ceramic Lava crowns on her bicuspids. Removal of old veneers can be very tedious if they were bonded correctly as was this situation. Diagnostic Wax Ups - Patient Input Once we removed the discolored, dull, old veneers, we prepared all nine front teeth, took a final impression and placed temporary veneers. The temporary veneers were made using a template derived from a diagnostic wax-up of which the patient approved. Patients are given access to a large photo gallery of different smile designs and photos depicting tooth shapes, textures, and translucencies. Based upon the patient's interests and technical data, a prescription is sent to the lab to fabricate the veneer products. Patient input and final approval of the cosmetic result via wax modeling assures success and eliminates dissatisfaction. Cosmetic Surprise After placing her temporaries, an interesting situation followed. We used a bleach shade for the temporaries which immediately drew attention to her new smile. The patient was told that if there were any changes to contact us within the next few days. Well the next day the patient called and insisted on returning to the office right away. When she came in she said that the first thing her husband saw was that we made a error and her midline was off! She never realized that all these years her midline was off, nor did her husband ever notice it. He never really looked at her teeth because they were, frankly, unattractive. Now, all of a sudden WOW! Look at those white teeth and the shape of the lips. Once we showed her a picture of her old veneers she realized that because of that missing tooth, her midline had shifted. Fortunately, most people, except her husband, do not visually perceive that a midline is off unless it is more than 3 or 4 mm. Two weeks later, the patient received her new smile of six DaVinci porcelain veneers and three Lava crowns. As can be seen in the adjacent after photo.. the outcome was very dramatic. Visit our Photo Gallery to see more examples of how Dr. Pohl performs porcelain veneer dentistry for a variety of dental needs. Have questions about veneer replacement? Contact Dr. Pohl to arrange a consultation for learning more about the differences and advantages of both no prep veneers and regular porcelain laminate products. Obtain the objective information you need for making an informed decision about veneer dentistry. 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