No prep veneers

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  • #26022
    Amit Kumar
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    Registered On: 26/01/2024
    Topics: 3
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    The patient is a successful physician who desired an improved smile but did not want to “shave down” his teeth.

    No prep veneers were delivered from the upper second bi-cuspid to the second bi-cuspid on the contra-lateral side.  No temporaries were needed.

    The patient also wanted to include his lower anterior teeth, however,Pre opPre op right sidePre op left sideTry in right sideTry in left sideFinal 1Final 2 there was not enough clearance to accomplish this using no-prep technique.

    You can note that the upper central was lengthened by 20%.

    Courses I've taken:
    Hornbrook Comprehensive Aesthetics - Dr. David Hornbrook
    Hornbrook Ultimate Occlusion - Dr. David Hornbrook
    Hornbrook Full Mouth Synergy - Dr. David Hornbrook
    PowerProx Six-Month Braces - Dr. Rick DePaul
    Invisalign Certification 1 & 2
    DOCS – Oral Conscious Sedation
    Implant Seminar's 8-month Continuum - Dr. Arun Garg
    Botox and Dermal Fillers - DentaSpa Seminars
    MALO Advanced Oral Rehab - All-on-X - Dr. Paulo Malo
    Teeth-in-a-Day - Dr. Tom Balshi
    Dental Sleep Medicine -

    #26023
    doctorsorabhjain@gmail.com
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    Registered On: 21/05/2016
    Topics: 10
    Replies: 6
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    Nicely done.

    Few queries?

    1. Any mock trial was done?

    2. Pts canine were attrited, what could be the reason?

    3. What material is this veneer?

    4. What was the Bonding Protocol?

    5. It would have been difficult to hold, so what was used to hold the veneer and what was the sequence used?

    6. Was this done on semi adjustable articulator?

    7. How have you decided to increase by 20 percent, as wouldn’t it be in accordance to eminence slope, was it taken into consideration and how?

    8. What Post Cementation care was Advised to prevent fracture?

    9. Where is the location of junction of veneer onto teeth Palatally?

    10. What occlusal guidance scheme was followed?

    Thank you in advance.

    Dr. Sorabh Jain | Cranio-facio-Mandibular Prosthodontist | Special Interest in TMJ management| Special Interest in Dental Sleep Medicine | Neuromuscular Principles Based Dentistry | DIgital Occlusion | Complete Dentures

    +91-7303302651
    www.DrProstho.com

    #26047
    Amit Kumar
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    Registered On: 26/01/2024
    Topics: 3
    Replies: 3
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    Hello Dr. Jain

    My apologies for the late reply.  I did not see your response.  Thank you for your feedback.

    Please see my answers below:

    1. Any mock trial was done?

    No mock trial was done.  I typically get a wax up done for my prepped cases, but given that this was a no-prep case, no wax up was needed

    2. Pts canine were attrited, what could be the reason?

    The patient suffers from GERD and grinds his teeth, but does not have sleep apnea.  For this reason, we provided him with a night guard (NTI) post-cementation and advised him to see his primary care physician to manage the GERD.

    3. What material is this veneer?

    The material is eMax

    4. What was the Bonding Protocol?

    I use VarioLink Esthetic cementation protocol.  I’ve attached the instructions for your perusal.

    5. It would have been difficult to hold, so what was used to hold the veneer and what was the sequence used?

    I always use Pic-n-Stic from Pulpdent to hold each veneer.  This makes handling much easier, especially for large cases.

    6. Was this done on semi adjustable articulator?

    Yes

    7. How have you decided to increase by 20 percent, as wouldn’t it be in accordance to eminence slope, was it taken into consideration and how?

    Initially, the patient wanted to have his lower anterior teeth incorporated into the design, however, he wanted no prep.  We determined this was not possible as there was not enough clearance due to the anterior coupling being tight.  We did not decide to increase the length by 20% from the start.  This was determined after the case was mounted.

    8. What Post Cementation care was Advised to prevent fracture?

    I put the patient into a FDA approved appliance call NTI (nociceptive trigeminal inhibitor)

    9. Where is the location of junction of veneer onto teeth Palatally?

    As these are no-prep then is no junction that rests ‘onto’ the teeth.  The finish line is at the junction where the natural tooth ends.

    10. What occlusal guidance scheme was followed?

    We did not alter the occlusal scheme.  It was bi-lateral balanced before we started.  The canines have worn down but typically I like to restore them with canine guidance.

     

     

    Courses I've taken:
    Hornbrook Comprehensive Aesthetics - Dr. David Hornbrook
    Hornbrook Ultimate Occlusion - Dr. David Hornbrook
    Hornbrook Full Mouth Synergy - Dr. David Hornbrook
    PowerProx Six-Month Braces - Dr. Rick DePaul
    Invisalign Certification 1 & 2
    DOCS – Oral Conscious Sedation
    Implant Seminar's 8-month Continuum - Dr. Arun Garg
    Botox and Dermal Fillers - DentaSpa Seminars
    MALO Advanced Oral Rehab - All-on-X - Dr. Paulo Malo
    Teeth-in-a-Day - Dr. Tom Balshi
    Dental Sleep Medicine -

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    #26072
    doctorsorabhjain@gmail.com
    Offline
    Registered On: 21/05/2016
    Topics: 10
    Replies: 6
    Has thanked: 0 times
    Been thanked: 1 time

    Thank you for your reply.

    Great case.

    Keep it up…

    Few doubts here…

    1. When u used nti, how long will u advise to use? Can u share design or picture of Nti, u mentioned in Q2 and in Q8, as i suppose both would be different or same?

    2. For Q9, can u please share image as to where the junction lies as “where natural tooth ends” i couldn’t understand, hence requesting to paste an image for this as well? If no image, then can u please show through schematic diagram,if possible?

    3. Purpose of asking Q6 and Q10, was when you alter anterior guidance, that means when u said tight anterior contacts, then it would be steep or shallow? Also how much Occlusal clearance did u kept, reason for asking this is as we have veneer debonding or failures related, wanted to know what clearance u kept during static and dynamic movements?

    Would love to watch future cases as well as long term follows up of the same case.

    Thanks once again for sharing a nice case.

    Apologies for so many queries…

    Dr. Sorabh Jain | Cranio-facio-Mandibular Prosthodontist | Special Interest in TMJ management| Special Interest in Dental Sleep Medicine | Neuromuscular Principles Based Dentistry | DIgital Occlusion | Complete Dentures

    +91-7303302651
    www.DrProstho.com

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