Ceramic veneers in dental esthetic treatments

Abstract

Aesthetic treatment of the anterior teeth has always been a challenge in clinical practice. Along with the evolution of dental materials, the number of therapeutic options increased: in addition to aesthetic fillings or direct composite resin veneering and all-ceramic crowns, ceramic veneers and inlays are now available. In these circumstances, dentists and their patients can choose the best therapeutic option from a range of possibilities outnumbered 15–20 years ago. This choice is based both on the study of aesthetic criteria and the patient desires in accordance with therapeutic needs that he has. The commonly used material for aesthetic restorations is dental ceramics, due to its color stability, biocompatibility, mechanical properties, and excellent aesthetic results. Minimally invasive dental restoration idea is gaining more ground in current dental practice, and thus full-ceramic veneers are increasingly used. There are three types of ceramics used for manufacturing these veneers: feldspathic ceramics, leucite-reinforced glass ceramics, and lithium disilicate-reinforced glass ceramics. All these have special optical and aesthetic properties, miming natural tooth appearance, but the mechanical properties are different. As full-ceramic veneers are single-tooth restorations with very low thicknesses, mechanical resistance of the material is important both for their handling during manufacturing phases or intraoral cementation and especially for preserving the integrity of the restoration in the oral cavity. Teeth preparation techniques for full-ceramic veneers differ depending on the aesthetic needs of the patient, the type of veneers to be made, and their indications and contraindications. Operator protocol includes four treatment sessions at the end of which the patient has the veneers cemented on the natural teeth. There are many advantages of natural teeth veneering and some disadvantages, which are small compared to the benefits. The survival rate of full-ceramic veneers is very high, with some authors communicating a percentage of 96 % ± 2 % at 21 years and others of 95.6 % at 10 years.