No prep veneer case. Ingot choice?

[eethanshire]

Hi guys,

I have found myself in a predicament. Dentist wants to do 10 (1.5 - 2.5) no prep veneers with this particular case to close diastemas and create a lighter uniform shade throughout
Cervical - A4
Middle - A35
Incisal - Slightly more trans than D3 trans

I have consulted with two other people and they are telling me two different things. Use LT block to mask dark shade but I have read that LT block is not a suitable choice for stumps A4/C4.
Another tech mentioned Impulse ingots for enamel replacement. This sounds good but how are we to change the shade lighter.

Thoughts?

 

[TheLabGuy]

I'm confused, what is the final shade desired?...and what is the stump shade?

 

[sidesh0wb0b]

LT should be fine. HT might show through a bit on margins, but also might work out well. If you have enough room for a slight inc cutback I'd go LT but that's me

 

[user name]

Look at the heavy wear marks. Hes not a good candidate for veneers.

 

[doug]

Those centrals are gonna be like fan blades

 

[user name]

Those centrals are gonna be like fan blades

Yup. Do a diagnostic wax up, and dont try to over-sell the possibilities. No golden proportion with this one.

 

[dmonwaxa]

This no prep just might be a no go.

 

[desertfox384]

No prep and he wants it bulked out 1.5-2.5 !? Impulse won't be a good candidate.. It's more trans than Lt and will have a harder time evening out the shade.. Lt may work if it's kept realy thick.. I believe ivoclars guide calls for ho ingots at least 6 tents to block out a shade this dark.. But I guess it all depends on what doc wants the final shade to be.

 

[rkm rdt]

Hi guys,

I have found myself in a predicament. Dentist wants to do 10 (1.5 - 2.5) no prep veneers with this particular case to close diastemas and create a lighter uniform shade throughout
Cervical - A4
Middle - A35
Incisal - Slightly more trans than D3 trans

I have consulted with two other people and they are telling me two different things. Use LT block to mask dark shade but I have read that LT block is not a suitable choice for stumps A4/C4.
Another tech mentioned Impulse ingots for enamel replacement. This sounds good but how are we to change the shade lighter.

Thoughts?

I would try bonding to the teeth first.

 

[martintay]

Impulse "V" Ingots - job done ! Press in either V1 , V2 , V3 depending on final required shade . Great results with stain & Glaze . IMO Ivoclars best / most versatile ingot - No "Greying " and good masking ability. They are more expensive though !

 

[Tad Philip]

Bad choice for another lazy dentist!!! Seriously, is he going to discount the patient for his "no prep veneers"? that saves him tons of time and more work for the lab, not! Tell him to prep those veneer right and give the patient quality restoration he is paying for!

 

[Mrs.galfriday]

I would love to see a diagnostic closing the diastema with out pinching the central papilla. I just cannot design this successfully. He needs corrective positioning first.

 

[Labwa]

RUN!!! no ingot will change the fact that these are going to be under extreme force and the difficult contours you are having to correct.

 

[eethanshire]

thanks for the replies I appreciate the input and perspective.

Dr. came back from a durathin course coming back home with high expectations from what the course promised and what is possible thus the ambition to do no prep veneers. Some of what he was telling me sounds absolutely preposterous, but he believes every word they told him despite me saying otherwise.

There is no real desired shade, something lighter than what he has but the primary goal is to close the diastema.

Everyone I have asked including this thread, have provided me with difference answers regarding ingot choice - every ingot except HO and MO.

I will make test veneers and choose the best of the lot. thanks for all the response I appreciate the help.

 

[Glassman]

thanks for the replies I appreciate the input and perspective.

Dr. came back from a durathin course coming back home with high expectations from what the course promised and what is possible thus the ambition to do no prep veneers. Some of what he was telling me sounds absolutely preposterous, but he believes every word they told him despite me saying otherwise.

There is no real desired shade, something lighter than what he has but the primary goal is to close the diastema.

Everyone I have asked including this thread, have provided me with difference answers regarding ingot choice - every ingot except HO and MO.

I will make test veneers and choose the best of the lot. thanks for all the response I appreciate the help.

No prep veneers are not going to have enough room to layer porcelain to kill the value of those ingots. If the patient wants white then no problem.

 

[dmonwaxa]

You can try a pmma mock up.

 

[Patrick Coon]

I wold not use an HT or an Opal ingot at all for this case. Unless of course you want very low value restorations in the diastema area.

I think the PMMA mock up is a great idea to check the thicknesses you will have and if the patient will even tolerate it.

If you do go ahead with the case, a Value ingot (any, depending on how bright you want) would work to even out and brighten the shade slightly.

I would also insist the doctor at least smooth off the rough, uneven incisal edges on #8&9, to create better margins and remove sharp areas on the "prep".

Just my 2 cents.

Have a great night!

 

[eethanshire]

Thanks Patrick, that helps.