Dental Education

All too often, the importance of porcelain veneer temporization is overlooked. For the clinician to have a satisfying outcome, there are steps in sequential fashion that must be followed. The meticulous completion of the porcelain veneer temporization stage is paramount to insure clinical success. The benefits are many:

• Allowing for all involved to reduce errors;
• Visualize the end results;
• Make final appointments smoother.

Procedure

The preparations are carried out according to the dictates of the study models and the lab fabricated matrix guide. The preparations are then cleaned with sodium hypochlorite so that remnants of the impression material or smear layer are removed.

The preparations are then spot etched with phosphoric acid at the centre of each tooth. After 10-15 seconds the preparations are washed with copious amounts of water.

A clear matrix stent, which is formed from an impression of the diagnostic wax up, is then used as the template for the veneer temporaries. Using the desired shade, the matrix is filled with a flowable resin covering the buccal surfaces of all the prepared teeth and then set aside in a dark area.

The etched preparations are treated with an unfilled bonding resin at the spot etched position and around the margins. Each tooth is then cured for 30 seconds. The placement of the unfilled bonding resin at the body of the tooth aids in retention while the coating of the margins assists in reducing intra operative sensitivity. It is imperative to note that only unfilled bonding resin can be used for this technique. If a filled resin is substituted at this stage, the subsequent removal of the temporary veneers will become difficult and may result in potential damage to the teeth.

Once all teeth have been bonded, the stent containing the flowable resin is seated into position and cured from the buccal and the lingual for 30 seconds per side. Once curing is complete, the stent is removed and cured again. The clinician may notice small voids either at the surface of just below. Using a small burr they can be accessed, bonded and filled with the same flowable resin.

To remove the excess resin, a diamond tip aesthetic trimming burr can separate the flash from the legitimate margin. The procedure is done slowly by laying the tip of the burr almost parallel to the emergence profile as each margin is reduced. It is important to open the gingival embrasures so that they do not impinge the papilla and be easily cleansed. The body of the temporary veneer is developed and shaped. With the help of a football shaped diamond trimming burr, the lingual surface is contoured and smoothed. Though the temporary veneers are fabricated in one piece, embrasures are simulated on both the buccal and lingual surfaces.

To add additional characterization, diamond impregnated strips are used to soften corners and create incisal embrasures. The restorations are finally polished with a polishing paste to add luster to the temporary veneers prior to dismissal.

At this time the patient is encouraged to do warm salt water rinses twice a day, until the insertion appointment, to aid in gingival repair. The patient is also advised that, though the restorations are secure, they are placed with enough bond to hold them in place but not too much to prevent their easy removal at the permanent insertion appointment. As such, a soft diet is to be followed. In addition, because there is lack of a total seal at the margins, the patient may feel intra-treatment sensitivity.

See also: Dental Veneer
Source: Oral Health Journal