Table of Contents

Practice Building
Roundtable
Continuing Education
Esthetics
Restorative

Inside Dentistry

November/December 2010, Volume 6, Issue 10
Published by AEGIS Communications

The DAL Partial Prep Veneer

R. Scott Clark, and Gary Radz, DDS

Ultra-thin veneer options using a no-prep or partial prep philosophy.

Now with improved material selection, predictable enamel bond strength, and enhanced design concepts, a new debate has risen in the world of porcelain-veneer preparation design-preparation versus no preparation. The debate stems from a concern that a no-preparation design will have potential negative effects from compromised soft tissue health at the margin resulting from an over-contoured restoration; an unesthetic final result that is monochromatic or opaque; and an unstable veneer with inadequate strength. This debate has been fueled by dentists observing esthetic and functional failures of no-preparation veneers that were often fabricated in a less than esthetic manner and placed without proper case planning or experience in this technique.1

DAL and Dr. Gary Radz have developed a new no-preparation or partial-preparation veneer concept that can and does work-the DAL Partial Prep Veneer. Dentists need to understand that, as with any procedure, this technique has its limitations and can be as challenging, if not more so, than conventionally prepared veneers. A no-preparation or partial-preparation case often requires a certain amount of enamel contouring. However, there are several unique advantages that can be obtained for the clinician and the patient with this technique when properly administered, such as: non-invasive contouring or enameloplasty; it usually does not require an injection or temporization; and it is non-destructive of vital tooth structure.

The DAL Partial Prep Veneer System meets the desired criteria and provides dentists and patients with a very predictable, strong, and esthetic end result with minimal to no preparation. Several key factors must be followed and evaluated: proper case selection; proper material selection allowing a stable, esthetic 0.3-mm porcelain veneer; and maximum communication with an experienced DAL Partial Prep Veneer technician.

Case Selection

According to Lowe, the best no-preparation or partial-preparation cases are those where nature has made the space already, such as diastema closure cases, microdontia (peg laterals), or excessive wear cases.2 Wells gives the following parameters of cases that have high success potential3: bicuspid extraction orthodontic cases; short, worn teeth (assuming occlusion/bite forces are managed); misalignment in which one or more teeth are in a lingual position; cases in which teeth need more "presence" (big lips and small teeth); and narrow maxillary incisors with diastema(s) or wide incisal embrasure form.

Material Selection

DAL has developed the DAL Partial Prep Veneer, which incorporates IPS e.max® pressed lithium disilicate (Ivoclar Vivadent, http://www.ivoclarvivadent.us) in combination with a unique layering process. This combination produces outstanding esthetics, maximum strength (400 MPa) and can be pressed easily into 0.3-mm thickness with very accurate fit and precise restorative margins. The material is strong and esthetic enough to allow the DAL technician to precisely finish the margins down to 0.1 mm, allowing for the clinician to experience minimal marginal refinement and polishing at the insertion appointment.

Communication

The DAL Partial Prep Veneer System is an evaluation-based system anchored in functional and esthetic design. Dentists should provide the laboratory with: the patient's primary complaint; the patient'sexpectations and goals; impressions/ models; bite records; facebow or stickbite; photographs-full face, preoperative smile, lip at rest, retracted photo (teeth closed), retracted photo (teeth separated), lateral views, and occlusal views; notification of existing restorations on teeth involved; shade-both existing and desired; and plans for soft tissue recontouring.

In return, an experienced DAL technician will mount casts, determine any necessary preparation or slight recontouring, and send back: a study model; a complete diagnostic wax-up; a matrix from the diagnostic wax-up; a preparation model (with minor contours and any necessary preparation areas illustrated); and a consultation sheet-tooth by tooth.

For more information, contact:
Dental Arts Laboratories, Inc.
Phone: 800-227-4142
Web: http://www.dentalartslab.com

Disclaimer

The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products or services or their effectiveness, quality, or safety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the preceding material.

References

1. Radz GM. Porcelain laminate veneer therapy: Ultra-thin veneer options using a no-prep or partial-prep philosophy. Inside Dentistry. 2010;5(4):52-58.

2. Lowe RA. No-prep veneers: A realistic option. Dentistry Today. 2010;29(5):80-86.

3. Wells DJ. Don't we all do cosmetic dentistry? Dent Econ. April 2007;106-108.

About the Authors

This article was written by R. Scott Clark from Dental Arts Laboratories, Inc, and Gary Radz, DDS, of Denver, Colorado.