Veneering of teeth ceramic and composite materials

"SMILE" the most beautiful of all expressions. Today's era of cosmetic and esthetic dentistry has placed emphasis on a confident and captivating smile.The modern dentistry offers numerous treatment modalities for smile modification.Veneering of teeth ceramic and composite materials are important in esthetic dentistry-It is defined as the art and science of dentistry applied to create or enhance beauty of an individual within functional and physiological limits. and cosmetic dentistry-It is a application of the principles of esthetics and certain illusionary principles, performed to signify or enhance beauty of an individual to suit the role one has to play in their day to day life or otherwise.

The most conservative and highly effective therapeutic options are the ceramic and composite laminate veneers. Laminates-These are given when the teeth are discolored but their shape, size and position in the arch are normal. and veneers-These are given when the teeth need change in their shape, size and position in the arch. are interchangeable terms. The only different is in laminates the overall shape is not changed while in veneers the shape of the tooth is changed.

Based on use of materials veneers can be classified into Indirectly fabricated veneers and directly fabricated veneers.

A. Indirectly fabricated veneers:
These are laboratory fabricated veneers developed on a cast of the patient's mouth.
Further the indirect fabricated veneers can be subdivided according to the materials used as follows

  1. Composite
  2. Etched porcelain:this is sub classified into conventionally baked porcelain and cast porcelain veneers.

Indications for porcelain laminate veneers

  • Multiple discolored teeth. (tetracycline, fluoride etc)
  • Multiple teeth with enamel defects and unsatisfactory
  • multiple teeth with spacing or diastema
  • Microdontia, conical teeth, malformed teeth
  • Teeth discolored from fillings such as amalgam etc
  • Teeth with buccal caries involving enamel
  • Teeth with abrasion or attrition

contraindications of porcelain laminate veneers

  • Teeth with insufficient coronal tooth structure less than one half of coronal tooth structure remains.
  • Patient with para functional habits such as Bruxism.
  • Teeth with insufficient or inadequate enamel for sufficient retention ( severe abrasion).
  • Teeth exhibiting severe crowding.
  • Patient with severe periodontal disease.
  • Teeth that are still actively erupting (young permanent teeth).

Advantages of porcelain lamintae restorations

  • Excellent esthetics: porcelain offers excellent esthetics and inherent direct laminate veneers, the porcelain laminate veneer depends less on the esthetic skill of the dentist.
  • Excellent long term durability: porcelain is abrasion resistant and color stable. Excellent resistance to fluid absorption.
  • Inherent porcelain strength: porcelain exhibits excellent compressive, tensile and shear strength when bonded to enamel.
  • Marginal integrity: porcelain restorations bonded to enamel exhibit exceptional marginal integrity.
  • Difficult in color matching: although color is stable, precise matching of shape or shade to an adjacent tooth is difficult. In addition shade is impossible after cementation.
  • Irreversibility: Tooth reduction, although often minimal is required.
  • Inability to trial cement the restoration: bonded porcelain restorations can not be temporarily retained with provisional cement for evaluation purposes.


B. Directly fabricated veneers:
These are composite resin materials applied to the tooth surface freehand by the clinician.

Direct composite veneers
Three primary indications for direct composite labial veneers

  1. White spot lesions.
  2. Severe fluorosis discoloration.
  3. Severe hypo plastic discoloration.
  4. Because the discoloration is confirmed entirely to enamel and never extends into dentin.

Choice to composite materials:
if occlusion is normal and no stresses on the restorations the light - cured micro-filled composite material is the choice because of their superb polishability and overall esthetic acceptability. If occlusal factors are more demanding the Hybrid material would be the better choice.

Indications of direct veneers

1. Patients's who exhibit significant wear of anterior teeth caused by occlusal stress.
2. Low cost

Advantages of direct veneers

  1. Can mask dark stains more esthetically than direct bonding.
  2. No anesthesia usually required.
  3. Can easily be repaired in the mounth if and when staining or chipping occurs.
  4. More consservative- Less tooth reductoion than crowing.
  5. Usually use experience.
  6. Color change possible.
  7. Less faigue to the patient and easliy manipulated.

Disadvantages of direct veneers

  1. Required two visits.
  2. Greater expense than bonded composites.
  3. More prone to chosive fracture  than procelian veneers.
  4. Can be irreversible procedures it much enamel is removed.
  5. Not as strong as procelain laminate.
  6. Comparable esthetics to porcelain but not comparable clinical longevity.

Recent advances:
Recently two hybrid indirect composite system have been introduced brilliant dentin and herculite XRV lab. Such materials offer potentially promising result for veneer. Heat cure hybrid composite are not only highly aesthetic but also are easier to fabricate than porcelain. Heat cured hybrid restoration are highly durable and fracture resistant and generally demonstrate better marginal adaptation than proclaim retroactions.

Author:Dr Sudhanva Gowda