Vertical Shoulder Laminate (VSL) Veneer

 Seven Reasons to Not Prep!

1. The failure rate of dentin-bonded veneers is much greater than those that are bonded to enamel. It is always optimal to bond veneers to enamel for both strength and long-term durability. Bonding porcelain to enamel creates a solid and secure bond, compared with bonding porcelain to dentin. This bond, when the techniques are done right, is even stronger than nature’s bond of enamel to dentin.
2. Prepping is sometimes done to compensate for material deficiencies. Pure and simple: It is the porcelain that makes the difference. For example, in the case of the Lumineers (DenMat) system and philosophy, the objective is to provide a safe and wear-, stress-, and microleakage-resistant, restoration that is highly aesthetic and that has been shown to last more than 20 years…all without preparation!
3. You may have an aesthetically beautiful result with a subgingival prepped subgingival margin, but patients will have a higher likelihood of gingival recession than with a supragingival margin. Additionally, with subgingival prepped veneers, there is a higher likelihood for other untoward periodontal reactions.
4. Even in cases of minimal prep, with slight overlaps and spacing for which some contouring should be done, one still rarely has to touch dentin or use anesthesia.
5. Postoperative sensitivity will never occur when intraoperative procedures have been performed without anesthesia, if the patient feels no sensitivity during the recontouring of one’s teeth. (Once a tooth has been anesthetized, it is impossible to distinguish between sensitive and nonsensitive tooth structure.) It follows that the need for endodontic therapy will simply not occur as a result of the no-prep procedure and subsequent restoration. Because no-prep veneer procedures are a noninvasive, pain-free procedure, excitement about the procedure can spread among patients.
6. In this procedure requiring 2 patient appointments, temporaries are unnecessary in no-prep veneers, so the procedure takes much less chair time than those requiring preparations with the associated fabrication and then removal time needed for provisionals. And by experience, I know how making, maintaining, and removing veneer temporaries can be quite stressful and time-consuming.
7. Cosmetic contouring that removes only nonsensitive tooth structure without placing any predetermined margins, creating a foundation suitable for placing no-prep veneers and creating optimal aesthetics, is the most conservative basis for beginning to put patients into porcelain veneers. In ideal recontouring cases, patients leave the office looking better than before the appointment began, even when their veneers have not yet been delivered. And they actually could remain without their veneers forever. This is how we used to improve smiles long before the ability of bonding to tooth structure existed.