Bonded veneers and/or onlays are regarded mostly conservative prostheses and outperform conventional crowns/bridges. New state-of-the-art adhesive systems allow for fabrication of extra thin veneers and facilitate the bonding on intact tooth surfaces.
Most preferably capping of endo-treated teeth is to be avoided as fully rivalled by veneering or onlay application.
Endodontically (root canals) treated teeth become mechanically weak and prone to fractures. Especially that occurs, if the volume of the remaining tooth is compromised by decay or large restoration. However, unless already pre-prepared for a crown, endodontically-treated posterior teeth can safely be restored simply with partial-coverage bonded restorations ( onlays, overlays). That approach results in preserving healthy tooth and avoiding extra costs (i.e. post&cores).
On treating anterior (front) teeth, bonded veneers are the treatment of choice, unless tooth structure is already damaged. Most noteworthly, no need for any restoration occurs, if anterior teeth are properly treated and their volume is adequately preserved (conservative obturation of root canals).
E-max (IPS Ivoclar) and zirconia ceramics produce the most natural-looking dental restorations.
From conventional PFM crowns to most sophisticated cad/cam ceramics, all porcelain systems present excellent optical attributes, if there is enough tooth volume. However, when the volume of teeth is moderate, optical integration must be attained with thin restorations. In such cases bonded ceramics demonstrate strong adhesion, mechanical robustness ,and outstanding optical emulation (translucency , opalescence, chroma,hue etc). Even on addressing ultra thin veneers or crowns, E-max (IPS Ivoclar) or zirconia restorations have excellent optical and mechanical properties.
Reasons to treat the worn dentition
- Deterioration of function (ie mastication, phonetics) and aesthetics over the years i.e. shortening of teeth resulting in aged appearance
- Tooth wear terminally evokes tooth pain. Thus intentional endodontic therapies are then performed being coupled with posts-and-cores, all resulting in compromised mechanical properties of teeth
- Teeth terminally become non-restorable
- Occlusion breakdown may evoke temporomandibular muscle dysfunction (orofacial pain)
Dental patients can be restored in a-day session with fixed prostheses. Our main concern is same-day rehabilitation with fixed prostheses either on teeth or on implants.
Upon treating large segments of dentition, new occlusion must settle. In such cases, fixed trial restorations (see: temporary restorations - transition to excellence) must be applied for an amount of time. Temporaries are too delivered same-day
Unless already over-prepared, teeth can be restored with veneers in 95% of the cases. Of these cases a significant number can be restored with prep-less veneers (ie. Teeth remain intact) and the rest with minimally invasive techniques (teeth reduction 0.3- 0.5 cm)
If there are only color issues to be addressed, bleaching techniques can best serve intact teeth, as they are totally safe. It is also to consider that non-invasive bonded ceramic/synthetic-resin restorations (veneers-onlays) can also be a very good option. They provide supreme aesthetics, durability and maintain tooth structure.