Prepless Veneers

So now that we have the margins pretty well finished down and we’ve got our occlusion pretty well dialed in, we’re getting down to some subtle finessing and things we can do to make the case look nicer. Many times with Durations, I find that once they are cemented in the mouth and once everything is very durable and sound and solid, we can sometimes go in and make some post-cementation contour adjustments that make a big difference.

So all ready on the central incisor we’ve gone in with some white stones and some finishing diamonds and we’ve flattened this area here in the mid gingival one-third a good bit to try and create a little more of a natural emergence profile from the root area to the clinical crown. So now we are going to use a diamond impregnated round wheel that many lab technicians like to use go in and smooth off this area and refinish it. We are going to start by using this large wheel and get the main bulky areas refinished and then we will comeback with some intraoral instruments and polishing things to get close to the tissue line. This is a diamond impregnated polishing wheel by Brassler. So once we have the bulk of it done, we will switch over to our intraoral products, basically the same products, this diamond impregnated polishing cup, which we can get down a lot closer to the tissue line. Continue refinishing the ceramic where we used some diamonds on it and we really don’t want to leave that rough surface. We want to come back and refinish the porcelain. All of the surface finish on these restorations, Mark has created by rubber wheel polishing and using instruments like this along with some Robinson bristle brush and some polishing paste at the very end. So we’re basically going to be able to go back and recreate the same surface he gave us by using the same instrumentation in the mouth. We just have to be careful that we go slow and not generate too much heat and of course we really have to respect the tissue line and try not to traumatize that excessively. Please rinse that off. Now we’re going to go to the next step up in this polishing sequence with a little finer cup. Put some air on that, please. So now we’re going to come back with the last in the series of this intraoral polishing kit by Brassler. Keep some light air on the teeth all the time so we don’t get them too warm. We’re going to try to create the high luster we had originally. So the last thing we do in our sequence of polishing is to use a Robinson bristle brush with some paste and again try to recreate that ultra shine and gloss that Mark had originally for us. And this is exactly what he uses in the lab on the bench. So we should be able to duplicate the end result real close intraorally as long as we are careful not to generate too much heat. Again, as long as we stay away from the tissue. So some of the very last thing we’ve done here is to really scrutinize her bite and her occlusion. Sheri actually came to me first with some bit issues and that’s how we have migrated through her treatments, starting with trying to get her joints comfortable and healthy and then moving forward into correcting the aesthetic glitches that came along with the mal-occlusion. What we have done throughout this whole process, first of all is made certain that we have a real nice centric relation position, that her joints are seated maximally, that her condiles are seated maximally and that she is very comfortable. We have been successful in accomplishing that. And then with our anterior prepless veneers we have been able to dial in and create some nice anterior guidance, which she has not had before due to all the wear. So (close together there for us Sheri) when she slides over to the right, we’re now catching this cuspid over here (slide out there sweetie) and maintaining some guidance on that right cuspid. (close together) On the left side very nicely we are sliding over to a nice cuspid guidance there, which has pretty much immediate disocclusion (now close together and move straight forward) we were also able to create even though our midline is off and we have some compromises here we were able to create an even incisal guidance here and balancing the forces between her anterior incisors as she moves forward. (So move back and together) And of course we have done our final polishing and smoothing on the lingual with our rubber wheels and various polishing instruments. And we are now ready to finally unveil what this new look entails for Sheri. OK Ms. Sheri, take this mirror and take a look at these restorations and see what you think. Aren’t they great? Oh my God. I sure hope you like them. They are fantastic. You like, Yes, I love them. Super, super. Thank you. OK, I have a couple of questions for you. After going through all of that, we didn’t use any anesthetic today and I know there were places along the way where that was not very fun but as a new prospective patient would you recommend that they consider being anesthetized for that process or do you feel like that it’s Ok to go on without it. It’s very much OK to go without it. I didn’t really feel that, there was a little bit of discomfort but it was very minimal, very minimal. And you feel like the trade off of being able to sit up and smile and to feel that what you got here is worth that. It makes a big difference. Would you comment on your experience with this process of not drilling on the teeth versus maybe going through a similar process where maybe we would drill on the teeth, in your mind is that a huge benefit as you looked into this process or would you have had the mentality that I want a pretty smile no matter what it takes. Well of course you want a pretty smile no matter what it takes but I had a crown put in the back of my mouth and they whittled away at what was left of that tooth back there underneath that crown and I would have given anything for that not to have happened. This is really just remarkable. When you think about having this kind of dental work done and not having your teeth underneath compromised in any way and being able to do it without anesthetic, it’s remarkable, it truly is.
As we move forward towards more conservative dentistry, Durathin prepless veneers offer your patient a better option than traditional prepped veneers. Of course, as Dr. Wells points out not everyone is a perfect candidate for prepless veneers, case selection is key. For a more comprehensive hand-on course demonstration, we encourage you to write Dr. Wells at info@drdenniswells.com and register to take one of his courses offered in the office. For our HDiQ Dental members we welcome your questions and opinions. To begin to chat with other professionals about the topic of prepless veneers or any other topic, simply go to the chat room and log in. Rest assured your voice is heard and we ask Dr. Wells to return occasionally to answer questions directed to him. At HDiQ Dental we are committed to becoming the standard by which the dental industry is judged. Thanks for watching; we’ll see you next time.