Veneers

In dentistry, a veneer is a thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. There are two types of material used in a veneer, composite and porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth, typically using a resin cement such as Panavia. In contrast, a porcelain veneer may only be indirectly fabricated.

Why use Veneers?

The advantages of using a veneer to restore a tooth are many. Very good aesthetics can be obtained, with minimal tooth preparation (i.e. drilling). Normally a reduction of around 0.5 mm is required for a porcelain veneer on a labial tooth surface. Composite veneers are becoming more popular as they are easy to repair, whereas porcelain veneers occasionally fracture. It can be very difficult to match the shade of an individual veneer to the remaining teeth, hence the tendency to place several veneers.

Veneers may be used cosmetically to resurface teeth, to make them appear straighter, and to possess a more aesthetically pleasing alignment. This may be a quick way to improve the appearance of mal posed teeth without need to use orthodontics. However, the amount of mal position of teeth may be such that veneers alone may not be enough to correct the esthetic imbalance. Instead, orthodontics would need to be used, or orthodontics combined with veneers. The dentist who places veneers must be careful since veneers could increase the thickness of the front face of the teeth. If the teeth are too thick on the face they may appear to stand out and push out the lips. The effect may be enough to give the patient a full or chipmunk appearance when the lips are closed. Veneers must also be created such that the patient bites into them with minimal force, otherwise they may chip off. Patients whose lower jaw protrudes out farther than their upper jaw, otherwise known as a class III bite, may not be good candidates for veneers because the teeth of the lower jaw may bite into the teeth of the upper jaw such as to potentially dislodge the veneers.

History

Veneers were invented in the 1980s by a California dentist named Charles Pincus. At the time, they fell off in a very short time as they were held on by denture adhesive. They were, however, useful for temporarily changing the appearance of movie actors'/ actresses teeth.

Research started in 1982 by Simonsen and Calamia revealed that porcelain could be etched with Hydrofluoric Acid and bond strengths could be achieved between composite resins and porcelain that were predicted to be able to hold porcelain veneers on to the surface of a tooth permanently. This was confirmed by Calamia in an article describing a technique for fabrication, and placement of Etched Bonded Porcelain Veneers using a refractory model technique and Horn describing a platinum foil technique for veneer fabrication. Additional articles have proven the long term reliability of this technique.

Today, with improved cements and bonding agents, they typically last 10-15 years. But patients who receive veneers should understand that they may only last 10-15 years and then may have to be replaced. This can be very expensive since porcelain veneers cost around $1,000 each in 2006 prices. They are said to be somewhat more durable and less likely to stain than veneers made of composite.