Failing Veneers

Failing Veneers

Porcelain veneer laminates have had a major impact in the area of cosmetic and restorative dentistry. Premium laminate products have also been beneficial, more recently, in correcting minor bite and occlusal problems.
Unfortunately there are increasing reports of veneers going bad or failing. Some are reported to crack, chip, or fall off entirely. Others have been reported to change color... literally within 48 hours.. to a blue or grayish color.

Veneers have also been reported to start causing pain and sensitivity to pressure and even food temperatures. A few unique reports also exist where veneers and/or the prepared tooth became a mismatch.... leading to the grinding down of the new veneer laminate.


Bad Veneer Dynamics

Specific cause and effect relationships exist for each type of veneer failure. Rarely, if ever, is a veneer failure problem related to a product failure or failure due to the constitutional properties of the laminate itself.

In cases where veneers pop off, crack or become loose the causal factor may be bruxism (teeth grinding), poor bite occlusal relationship, inadequate tooth preparation or a bonding failure. In some isolated cases it can be caused by inappropriate dietary habits (chewing ice, munching on corn nuts, etc.).

Theoretically, these issues should have been researched, discussed or diagnosed between the patient and dentist. Bruxism is a frequent hidden issue since many patients are not aware they clench their teeth, especially during sleep hours.

Patients with significant occlusal issues should be counseled to investigate alternative procedures that resolve those issues before veneer placement.

The diagnostic aspect regarding adequate tooth preparation and fabrication of the veneer "should be" managed through diagnostic waxup modeling. Some doctors however, due perhaps to a small number of veneer units to be placed, may forego the use of diagnostic waxups.

  Failed Veneers Before
Failed Veneers Before
 
 
Failed Veneers After
Failed Veneers After
A more popular cause and effect relationship exists between the intricate balance of the type of tooth preparation performed by the dentist and the actual brand and type of cementation product. Different cements have different properties and therefore require different types of preparation.


Bonding failures can also be a root cause for discoloration of the veneers, increased tooth sensitivity or mild pain (dentin not adequately sealed) and temperature sensitivity.

Integral to any bonding process, which includes bonding of crowns, is the effective management and elimination of contaminants. Special solvent compounds are used by doctors to remove this contaminants that can be air borne, caused by the patient's saliva and even a patient's breath...

In general terms, the best resource pool for obtaining near perfection in veneer dentistry is the group of accomplished dentists who:
  • Have had the most recent post graduate training in veneer dentistry (bonding techniques from 10 years ago are substantially different from today)
  • Are skilled in diagnosing problem issues and laminate repair techniques
  • Possess varied and unique experiences in multiple veneer placements
  • Routinely incorporate Diagnostic Wax Ups and Veneer Temporaries to assure patient satisfaction
  • Have in-office procedures for controlling contaminants
  • Have immediate access to a variety of cementation compounds for different types of tooth structure characteristics
  • Veneer dentistry is an extremely techniqe sensitive procedure. Dr. Scalzitti advises all patients considering veneer laminates to fully discuss their cosmetic goals, potential for bite or occlusal problems (suspected or fully evident), require the use of waxup modeling, use veneer temporaries and lastly, eliminate any dietary preferences that pose a risk to veneer failure.

Additionally, patients should ask to see representative samples (before and after photos) of veneer dentistry performed. In full mouth makeovers.... where the number of veneers are numerous and involve considerable investment, patients should ask to speak with previous makeover patients.


Replacing Worn Aging Veneers


Veneer replacement is becoming more common. This procedure, in our office, is assured to be comfortable and near effortless.

The adjacent before and after pictures represent a replacement of worn out and somewhat yellowed veneer product with premium feldspathic porcelain laminates.

Quality veneers can endure for 10 to 20 years... depending on the oral health habits of each patient. Worn veneers are removed and replaced with temporaries while the final veneer product is being fabricated.
Before & Afters
 
 


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