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Case Study
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Direct Intraoral Mockup as a Guide in Conservative Tooth Preparation for Porcelain Laminate Veneers

Learning Objectives:

Upon completing this case study, the reader should:

  • Be better able to visualize the process of preparing and placing porcelain laminate veneers
  • See how porcelain laminate veneers can be used to increase aesthetics in restorations

The recommended facial reduction for a porcelain laminate veneer is 0.5 mm to provide adequate stress resistance and space for the buildup of color. To avoid exposing dentin, this dimension must be determined with the preparations originating from the final volume of the restoration, since the mean thickness of enamel in the gingival third is approximately 0.3 mm to 0.4 mm. As the cervical area is critical, a diagnostic waxup on stone models during treatment planning is paramount and serves as a matrix for the fabrication of silicone indices that guide mockup, tooth preparation, and direct provisionalization.

A diagnostic template, directly fabricated using a bis-acrylic material on the silicone index, will guide tooth preparation. This procedure may also serve as a mockup: it is molded on the unprepared tooth surface and may be adjusted to accomplish the patient’s aesthetic expectations before tooth reduction. Accurate preparation can be accomplished following the thickness required for optimal restoration properties, and according to a conservative approach.

 

*Clinical Instructor, Restorative Dentistry, CETAO, São Paulo, Brazil; private practice, Curitiba, Brazil.

 

Related Reading:

  1. Magne P, Magne M. Use of additive waxup and direct intraoral mock-up for enamel preservation with porcelain laminate veneers. Eur J Esthet Dent. 2006 Apr;1(1):10-9.
  2. Behle C. Placement of direct composite veneers utilizing a silicone buildup guide and intraoral mock-up. Pract Periodontics Aesthet Dent. 2000 Apr;12(3):259-66; quiz 268.
  3. Rada RE. Controlling reduction in the preparation of porcelain laminate veneers. Gen Dent. 2010 Sep-Oct;58(5):e210-3.
  4. Cötert HS, Dündar M, Oztürk B. The effect of various preparation designs on the survival of porcelain laminate veneers. J Adhes Dent. 2009 Oct;11(5):405-11.
  5. Gürel G. Porcelain laminate veneers: minimal tooth preparation by design. Dent Clin North Am. 2007 Apr;51(2):419-31, ix.
  6. Calamia JR, Calamia CS. Porcelain laminate veneers: reasons for 25 years of success. Dent Clin North Am. 2007 Apr;51(2):399-417, ix.
  7. Chichoyan F, Vanheusden A. Bonded porcelain veneers. Rev Belge Med Dent. 2006;61(1):47-64.
  8. Lerner JM. Conservative aesthetic enhancement of the maxillary anterior using porcelain laminate veneers. Pract Proced Aesthet Dent. 2006 Jul;18(6):361-6; quiz 368.
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