Dr. Mark Sowell, Dallas Cosmetic Veneers Dentist Explains Differences in Tooth Reshaping for Veneers

By: Mark Sowell

In our Dallas cosmetic dentistry office our patients often ask how much of their tooth will need to be reshaped in order to place their dental veneers and the answer varies depending on the type of veneers they will be receiving. As a dedicated cosmetic dentist in Dallas I offer and recommend different types of veneers to different patients as their individual needs are unique.

One of the biggest differences between veneering systems is how much the tooth is to be reshaped before the veneer is placed. Each Veneer system has different requirements. This is done by the cosmetic dentist and is done in our Dallas cosmetic dentistry office. As a general rule the greater the desired change in shape, arrangement and color the more reshaping is desired. The more room the ceramist has the easier it is to make dramatic changes in color, shape and arrangement. A potential disadvantage is if the reshaping leaves the tooth with less than 50% of the bondable surface of the tooth in enamel, then the long term bond strength of the veneer is significantly reduced. Research outside of our Dallas cosmetic dentistry office shows that enamel bond is stronger long term than dentin bond strength. It also shows that the veneer will have strong long term bond strength as long as more than 50% of the veneer is bonded to enamel. In practical terms almost all situations can be treated with long term success as long as 50% or more of the veneer is bonded to enamel. If for some reason less than 50% of the enamel is left then turning it into a bonding crown will correct this retention problem.

Twenty year studies show enamel bond strengths stay strong while dentinal bond strengths decrease over time. The other issue is the more reshaping into dentin the more frequent occurrence of tooth sensitivity. This is dependent on the bonding technique of the cosmetic dentist and varies greatly from one dentist to another, but as a general rule all enamel bonding has no sensitivity and deep dentinal bonding has the most potential for post bonding sensitivity.

Tooth reshaping for veneers falls into three categories.

1. No or minimal reshaping all in enamel. Example Durathins Veneers.

Advantages- strong long term bond, no sensitivity, and reversible.
Limitations- unable to make as dramatic changes in color and arrangement, veneer often slightly wider and thicker than optimum.

2. Moderate reshaping of tooth. Greater than 50% of veneer bonded by enamel.

Advantages- 90% of all cases have enough room to achieve an excellent result in color and arrangement. With excellent bonding technique no long term sensitivity and good long term bond strength.
Limitation- not reversible, roughly 10% of cases cannot achieve optimum shape, arrangement or color.

3. Heavy reshaping- less than 50% of veneer bonded by enamel. These are the
Reshaping designs that cause most of the problems you read about.

Advantages- it is easier for the ceramist or dentist to achieve dramatic changes to shape, arrangement and color.

Limitations- decreased long term bond strength, more change of post treatment sensitivity, bonding more technique sensitive or demanding.

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Dr. Sowell and his entire team strive to offer unparalleled expertise in the fields of cosmetic, restorative and implant dentistry in Dallas. They understand that enhancing the health, function and appearance of your smile is a major decision. That is why Dallas dentist, Dr. Sowell and his dental care team are so dedicated to your well-being, both inside and out.

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