Question

AmyLouRDH · 09-25-2007, 06:09 PM

How do I know when to suggest to a patient veneers over crowns or crown over veneers? I know when they are virgin teeth a veneer is better; but they always seem to catch stain around the margins that never wants to come off. I just can not seem to bring myself to ever suggest veneers. Other than taking away less tooth structure I can not see the upside to a veneer over a crown any thoughts or has the prophy paste finally gone to my head.

Craig · 10-23-2007, 03:03 PM

Amy,

If you're seeing a lot of stain around the margins of the veneers and not the crowns, then I would suspect that the veneers' margins aren't up to par. Porcelain doesn't stain, but the bonding agent, that would seal the open margins, DOES. Typically, if the doctor preps the veneer with an interproximal elbow, or wipes out the contact, then most of the margins will be on the lingual or towards the lingual anyways. The facial margin should be just at or just below the gingival line, so the staining in any of those areas should be minimally noticed, if at all.

My thoughts on suggesting one type of restoration over the other is that its always dependent on the certain situation, and the desired results. Saving natural tooth structure is always a priority, but not at the expense of the final results. If your lab isn't producing the quality you require with their veneers, and you have a good relationship with them, then you might want to talk with them and show them what you're seeing in the mouth compared to what you want. Hopefully that will resolve the staining issues and you'll feel more confident suggesting veneers in the future.

Of course, those are just MY thoughts.

Craig

JEmirzian · 10-23-2007, 05:29 PM

Well said Craig.....

AmyLouRDH · 10-25-2007, 05:12 PM

Thank you so much for replying that is a lot to chew on. Honestly I just yell at the patient for drinking to much coffee I never get angry at the prep or the prepared veneer. Hmmm....

Craig · 10-25-2007, 05:36 PM

LOL You hygienists are always so MEAN to those poor patients... Just think of all the complexes you may have caused in their minds.

09-25-2007, 06:09 PM	#1 (permalink)
AmyLouRDH Junior Member Simon Champion! Join Date: Sep 2007 Posts: 20 Gallery: 0 Rating: 0% (0) Rep Power: 0	Question How do I know when to suggest to a patient veneers over crowns or crown over veneers? I know when they are virgin teeth a veneer is better; but they always seem to catch stain around the margins that never wants to come off. I just can not seem to bring myself to ever suggest veneers. Other than taking away less tooth structure I can not see the upside to a veneer over a crown any thoughts or has the prophy paste finally gone to my head.

10-25-2007, 05:12 PM	#4 (permalink)
AmyLouRDH Junior Member Simon Champion! Join Date: Sep 2007 Posts: 20 Gallery: 0 Rating: 0% (0) Rep Power: 0	Thank you Thank you so much for replying that is a lot to chew on. Honestly I just yell at the patient for drinking to much coffee I never get angry at the prep or the prepared veneer. Hmmm....

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10-23-2007, 03:03 PM	#2 (permalink)
Craig Junior Member Join Date: Oct 2007 Location: Fremont, Ohio Age: 35 Posts: 19 Gallery: 0 Rating: 0% (0) Rep Power: 0	Amy, If you're seeing a lot of stain around the margins of the veneers and not the crowns, then I would suspect that the veneers' margins aren't up to par. Porcelain doesn't stain, but the bonding agent, that would seal the open margins, DOES. Typically, if the doctor preps the veneer with an interproximal elbow, or wipes out the contact, then most of the margins will be on the lingual or towards the lingual anyways. The facial margin should be just at or just below the gingival line, so the staining in any of those areas should be minimally noticed, if at all. My thoughts on suggesting one type of restoration over the other is that its always dependent on the certain situation, and the desired results. Saving natural tooth structure is always a priority, but not at the expense of the final results. If your lab isn't producing the quality you require with their veneers, and you have a good relationship with them, then you might want to talk with them and show them what you're seeing in the mouth compared to what you want. Hopefully that will resolve the staining issues and you'll feel more confident suggesting veneers in the future. Of course, those are just MY thoughts. Craig

10-23-2007, 05:29 PM	#3 (permalink)
JEmirzian Moderator Alchol Test Champion! Join Date: Oct 2007 Location: Wilbraham, MA Age: 31 Posts: 135 Gallery: 1 Rating: 0% (0) Rep Power: 2	Well said Craig.....

10-25-2007, 05:36 PM	#5 (permalink)
Craig Junior Member Join Date: Oct 2007 Location: Fremont, Ohio Age: 35 Posts: 19 Gallery: 0 Rating: 0% (0) Rep Power: 0	LOL You hygienists are always so MEAN to those poor patients... Just think of all the complexes you may have caused in their minds.