Prep vs No-Prep ceramic veneers
In order to preserve health dental tissue as much as possible demand for non-invasive procedures increased over the last decade. In response to that use of porcelain veneers has become a common approach to treat worn, misaligned, fractured, discolored and malformed teeth. Furthermore, the clinical indications for such restorations have been progressively increased due to the development of new ceramic materials. With these new materials, we can achieve a greater reduction in thickness of final restoration and effective bonding to enamel, which directly affects the preservation of health dental tissue in harmony with the principles of minimally invasive dentistry. Porcelain veneers and porcelain no prep veneers offer the amazing smile makeover results, but the composition of, preparation for, and application of both these cosmetic restorations have some differences. It is difficult to compare these two types of restoration but we will try to compare the differences between them and the cases when they are really indicated.
can solve a lot of esthetic issues few appointments. Some of the most common indications for veneers are esthetic problems like multiple diastema cases, anterior dental wear, correcting minor misalignment and rotation of anterior teeth, altering malformed teeth, color changes, masking exiting class III, IV, and V restorations and restoring chipped or cracked teeth.
Ceramic veneers have been prefered treatmant used to treat diastemas for adult patients who refuse option of orthodontic treatment because of the lengthy process and the need for immediate esthetic results(picture 1). If the patients dont have major discorotaion non prep veneers are better option. With no prep veneers tooth tissue is preserved and treatment is more comfortable for the patient.
For immediate esthetic they are great solution. Despite the fact that this is a common indication, diastema closure can be done without any preparation only in limited number of cases. On the other side lack of diastema would be contraindication for non prep veneers. Without enough space non prep veneers can look bulky and over contoured, while prep veneers can provide great estetic result. For a lot of patients work without a drill and without anesthetic is a major benefit so we also need to consider this when choosing the method of treatment.
For them, the main criteria are no drilling, no shots and no removal of tooth structure. If these patients are much less concerned about estetic and the fact that their veneers will be slightly bulbous, we can chose the no-prep method.
The next comparison is aesthetic treatment of color changes. In cases with major color changes prep veneers would be better choice because it would be impossible to achieve bigger color changes with thin ceramic layer. For color change we need at least 0.2 mm of ceramic for every shade change. If we would try to change color for more shades they would look very artificial and flat due to lack of transparency and depth of co lour. Teeth will be white, but they will be more opaque white. So if we want to achieve drastic color changes and natural look prep veneers are better option.
In cases when we wont to achive correction or alteration in tooth shape or minor misalignments and rotations of anterior teeth prep veeners will be better solution. They can provide changes in morphology with translucency of natural tooth structure and great esthetic results. If we decide to treat this cases with non prep veneer it could easily result in teeth that are bulky and over-contoured. These overcontoured veneers wont be only an esthetic problem, but they can lead to gum problems, too. Also without preparation dimensions of the tooth will be larger and that can make new veneers hard to get use to.
Masking exiting class III, IV, and V restorations can be easily done with no prep veneers or prep veneers. They can mask existing restorations without removing any health dental tissue. But there are also some limitations. It patient have large class IV defects they would be contraindicated because of the large amount of unsupported porcelain and lack of tooth-colored backing.
When its indicated restoring chipped or cracked teeth with a no prep veneer is not only the most esthetic, but it is the most durable approach to repair. Ofcourse in cases wher teeth are significantly broken down or compromised crowns will be a better and stronger alternative than veneers. With no prep veneers bond can be partially in enamel and partially in dentin, depends on damge, which is adequate for most biting pressures. Bonding porcelain to enamel creates a solid and secure bond and long-term durability. In this case no prep veneers provide better bonding and also preservation of remining health dental tissue.