All-in-Four Veneers

I’ve completed many veneer cases, and most likely the patient is hesitant about the cost and how many.   Rightfully so.   Veneers can be quite expensive.   If you’ve read any of my other posts, or follow me on FB, you know that I’m already “aggressively conservative.”   I try to save tooth structure, always for function, and most of the time for cosmetic reasons (more on that later.)   So, if a patient needs to look better, but isn’t ready to throw $10K+ down to do it, they can get a LOT out of bleaching and four veneers.   Obviously, there are some limitations with this but the patient would be more accepting to those knowing that they are saving a lot of money in the meantime.   
This was a difficult case in that the occlusion was not great and his maxilla had a great cant.   But the overall outcome turned out pretty well, and he is very pleased.  

Ivoclar Vivadent’s Opal 1, Variolink Esthetic, and Adhese

 

 

In the video, you may notice that the midline is a bit to the right of the papilla.  Yes, this is one “sin” in cosmetic dentistry, but the spacing and cant were limiting factors.   I had to use what I had to work with, and I measured many different times during the wax-up. 

Aggressively Conservative:  Not Always

I’m extremely conservative when doing restorative dentistry.  I’ll avoid a crown every day of the week, if I can. The problem is that very few dentists were trained to do partial coverage, so they do a lot of crowns.   They don’t FEEL comfortable about leaving a cusp because it MIGHT break.  There are so many more factors in play, like occlusal patterns, that should warrant SAVING a cusp.   The best material for teeth is:  enamel!

With that said, when it comes to doing cosmetic dentistry you MUST remove enough to allow ceramics to be in a cosmetic presentation.   Under-reduced prepped teeth with veneers can look very unnatural!   You’ve seen them, I’ve seen them, and our patients KNOW that they look weird.  They may not be able to describe it, but they don’t want ’em.  I’ve never had a patient walk in my office and tell me that they wanted big, round, white, opaque veneers.   Not once.   🙂    So, prepare those teeth in order for the best opportunity for you, or your lab, to have room for the cosmetic outcome.  

 

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