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A technique for replacing existing porcelain veneers has been presented. Technique for smile design, tooth preparation, and cementation were described. The objective was to meet the patient's aesthetic expectations while also meeting functional requirements.
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Provisional restorations provide valuable clinical information for the definitive restorations. In the provisionalization phase, they guide the healing of the gingival tissues and allow the clinician to determine any necessary phonetic or aesthetic adjustments; provisional restorations also assuage patients' psychological concerns regarding their appearance. This article highlights the development of provisionalization procedures and describes disadvantages that have furthered the quest for improvements. An alternative technique for fabricating provisional restorations through an injection-molding process is demonstrated for the anterior maxilla.
Porcelain veneer restorations require close attention to detail from beginning to end. It is often prudent to go slowly when working with these cases. Patients receiving them have high expectations that go beyond considerations of function alone. Many problems are encountered when porcelain veneers are used to improve the appearance of the teeth. Avoiding and overcoming these problems first requires identification of the causes of the problems, followed by changes in clinical techniques. Success is the result of careful selection of teeth to receive veneers; preparing teeth in a manner that optimizes the aesthetic potential of the veneer; employing techniques that maximize the strength of both the veneer and its adhesive bond to the tooth; utilizing high-quality provisional veneers; insisting on a precision fit; and paying attention to the details of adhesive bonding protocols.
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PURPOSE: Transitional implants were designed to support provisional restorations and to allow for load-free osseointegration of conventional implants while a patient was provided with immediate esthetics and function. The purpose of this study was to evaluate the removal torque values of immediately loaded transitional implants in human subjects. MATERIALS AND METHODS: Thirty-one 1.8-mm-diameter transitional implants were placed in 4 patients to support provisional restorations and were subjected to immediate loading. Removal torque values were recorded using a modified ITI torque driver, which was calibrated on an Instron test machine. Torque values were subjected to analysis of variance and post hoc comparisons of means (P < .05). RESULTS: Twenty-six implants were removed intact with torque values between 10.5 and 22.9 Ncm, while 5 fractured at the bone crest at values between 27.1 and 35.4 Ncm. Mean torque values increased with time in function. These values were significantly lower in the maxilla (16.1 +/- 4.8 Ncm) than in the mandible (24.0 +/- 7.3 Ncm). DISCUSSION: Results suggest that these transitional implants may be safely removed from the maxilla after 7 to 15 months, but there is a risk of implant fracture during removal from the mandible after 10 months. CONCLUSION: Removal torque levels for these implants indicate varying degrees of integration even though they were subjected to immediate loading.
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Advances in dental materials and techniques have enabled porcelain laminate veneers to evolve into the treatment of choice for minimally invasive aesthetic dentistry. Treatment planning and tooth preparation are crucial for optimal function and aesthetics. While minimal invasion is important, sufficient space must be provided for the appropriate porcelain buildup. Various preparation guidelines have been advocated for porcelain veneers, yet they vary in accuracy and by indication. This article provides a simple, precise technique for veneer preparation regardless of tooth position and condition.
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