TODD C. SNYDER, DDS, FAACD The Nuts & Bolts of Veneers · 2020-04-17 · Provides bridge to clinical evaluation and presentation of options Creates EMOTION and DESIRE ... GC America

4/17/2020

1

The Nuts & Bolts of Veneers

TODD C. SNYDER, DDS, FAACD

Accredited Fellow, American Academy of Cosmetic Dentistry

Fellow, International Academy for Dental Facial Esthetics

Member of The American Society For Dental Aesthetics

Diplomat of the American Board of Aesthetic Dentistry

Former Faculty, UCLA Center For Esthetic Dentistry

Speaker, Catapult Education

LEGIONpride.com, Online Training Challenge for Dentists

Entrepreneur, 2 Software Companies, Author/Lecturer, Race Car Driver

Todd Snyder, DDS, FAACD, FIADFE, ASDA, ABADLaguna Niguel, CA

Aesthetic Dental Designs®

[email protected]

1

3

4/17/2020

2

Lecture Handout

www.DENTOOLZ.comDigital Handouts, Products I Use & Special Offers

(Bonus Slides)

Digital HandoutsLecture Schedule 2020

You will be emailed a link

to give you access.

4

5

4/17/2020

3

According to the American Academy of Cosmetic Dentistry 50% of patients are

unhappy with their smiles and 3 out of 5 people will invest in their smiles.

How Do You Get More Cases?

One of the most powerful & fastest tools you own to create cosmetic opportunities??

6

7

4/17/2020

4

WHITENING

Immediate Call to Action Motivator

Start Here

Over-the-Counter Teeth

Whiteners: $1.4 billion

(MSNBC) ...

(Consumer Reports).

8

9

4/17/2020

5

Over The Counter Whitening

Whitening

10

11

4/17/2020

6

Opalescence GO!• Fast, Easy, Effective, Better

Experience• Convenient & affordable

professional whitening to GO• Pre-loaded, disposable UltraFit™

tray for a custom-like fit• Molar-to-molar coverage• No chair time

12

13

4/17/2020

7

Reduce or Eliminate Sensitivity

• Potassium Nitrate & Fluoride

14

15

4/17/2020

8

Opalescence Go Sample Tower

“Total annual revenue in the teeth whitening industry topped $11 billion at the beginning of

2015, with $1.4 billion spent on teeth whitening products. These figures suggest a steady annual increase in the teeth whitening market industry, which is expected to continually climb over the

next 10 years” AACD Research

16

17

4/17/2020

9

Cosmetic Alterations

• How many of you want to buy something sight unseen?

• How many of you want to experience something first before investing?

• Your patients are no different!

• They are concerned about how it will look and feel. They want to be excited and happy!

• Don’t Just Tell…..Show & Tell!

18

19

4/17/2020

10

The Key to Success:

VisualizationWhat is the patient’s perception or desired outcome in their mind to create the EMOTION and DESIRE?

20

21

4/17/2020

11

YOU NEED CAMERAS

What do they want or envision?

Look at books or your cases.

Bring in examples of smiles.

22

23

http://www.instagram.com/Toddsnyderdds/

4/17/2020

12

Everyone has an opinion & priorities

How WHITE?

Translucency?

What Texture?

Color Transitions

What about example

pictures?

◆ Are they relevant and

realistic?

24

25

4/17/2020

13

REALISTIC

Photographic Manipulation

• Cosmetic “Imaging” Software• SmileFy app• PreVue app• SmileVision• DentalGPS• DSD

• Digital Agents• Virtual Smiles ($125/image)• DreamSmiles (<$4000 a year?)

• Less than an hour• Prevue• Evident

• Ivoclar/Kapanu?

26

27

4/17/2020

14

Why Does this Work?

✓Creates awareness

✓Suggests the possibility

✓Promotes discussion

✓Provides bridge to clinical evaluation and

presentation of options

✓Creates EMOTION and DESIRE

Digital Smile Mockup

-is a proven practice building program that can:

Dramatically increase your patient’s interest in a smile

transformation

Remember, 50% of your patients want to improve their

smile

The goal is to help them visualize themselves with an

improved smile

28

29

4/17/2020

15

When you hand a Digital Simulation to your patient, you plant a seed of what is possible, a constant reminder of what their potential new smile can be. They can show it to their friends and family, you can put a copy in their chart for follow-up, have them hang it on their refrigerator...!

30

31

4/17/2020

16

Overall Feel

Appearance…what is it? who decides, Dentist? Ceramist? Patient? Combined effort?

THEIR DECISION √

BUT YOU HAVE TO GUIDE THEM

32

33

4/17/2020

17

The Key to Success:

Traditional Veneers

Diagnosis & Treatment Planning

The Key to Success:

34

35

4/17/2020

18

Traditional Veneers

36

37

4/17/2020

19

38

39

4/17/2020

20

You are selling the Emotion…

Do you know “THEIR” desired outcome?

40

41

4/17/2020

21

42

43

4/17/2020

22

44

45

4/17/2020

23

• There never seems to be enough of it…

• It has to be built into the schedule or out source to employee

• Take the time to huge profit

• Know what the case is going to entail ahead of time

• What is the patients Chief Complaints?• Pick 3 to address

• Why do they have these problems?

• Are they going to drive you crazy?

Time

• Immediate Smile Change Consultation?

• Can they come back in a week?

Time (CONSULTATION)

OR

46

47

4/17/2020

24

-Patient wants to fix the small

lateral incisor

-No tooth reduction

OPPORTUNITY

48

49

4/17/2020

25

Beadline Provisional Mockup

Beadline Provisional MockupBeadline Provisional Mockup

Diagnostic Models with a waxup are duplicated. Special over impression is created and used to deliver temporary mockup

50

51

http://d1ue90e5sp4tcv.cloudfront.net/668/images/Grid_Image_20945_22_v1.pdf


4/17/2020

26

LISTEN For Yourself

52

53

4/17/2020

27

Show & Sell Possibilities..

COSMETICChanges

3 out of 5 • Patient came in to fix small lateral incisors

• Wants “Absolutely” no tooth reduction

• What drives him?• Appearance

• No Tooth Reduction

• Emotion

• Desired Outcome…. Feel Better, more confident?

54

55

4/17/2020

28

Results

Confidence, Dating,Work,Emotional Goals

Cosmetic Dentistry

• Do YOU WANT more Cosmetic Cases?

• Patients desire a change• But don’t know what they want (typically)

• What are their Chief Complaints (pick 3)

• Why?

• And What will that accomplish? Reasoning behind Tx.

• Always look at the big picture

• Take photos

• Write down where they can see their Chief Complaints• Signature on waxup

• Signature on provisionals

• Signature for final cementation approval

56

57

4/17/2020

29

How Do We Create The

Intraoral Mockup?

• First take an impression of teeth with a material that allows you multiple repours.

• Want one original model

• One model for laboratory

• Extra model if you need bleach trays or practice preparations

• Photos

• Facebow

• Horizontal Plane Indicator

• Teeth that are too far facial will remain untouched. When photos are taken they will be less obvious.

Final Impression

• Pack #00 ReCord

• Take final impression with light body PVS (Affinity) and heavy body PVS (Affinity) tray material

• Use a custom HeatWave Tray

58

59

4/17/2020

30

Final Impression

Final Impression

60

61

4/17/2020

31

Final Impression

Final Impression

62

63

4/17/2020

32

REVIEW

• Existing In Office Patients (3 out of 5) want to fix their SMILES!

• Shade Evaluation every exam & everyone in Hygiene Department

• Website, Social Media Accounts all setup and posting RELEVANT content

• Photos of everyone to send home (possibly with imaging) GET A CAMERA

• Take a photo and do a Cosmetic Simulation/Mockup

• Instant visualization through software on an iPad or possibly internet

• Instant Composite Mockup in the dental chair

• Take an impression and have lab do a waxup to facilitate a Beadline

Provisional Mockup (reduced fee or no fee agreement with lab)

Diagnostic Models & Records

64

65

4/17/2020

33

Silginat - Kettenbach

Counter FIT- Multipurpose Replication Silicone

(Clinician’s Choice)

Counter FIT- Multipurpose Replication Silicone

(Clinician’s Choice)

Silginat - Kettenbach

66

67

4/17/2020

34

Wear Facets & Interferences

3 Sets of Models-One is untouched for legal documentation-Second to practice preparations (It will be waxed up)-Third is a spare to practice on or make bleach trays

Mounted and Equilibrated

68

69

4/17/2020

35

—MEG BIRAM

70

TRAIN

Are you confident in creating beautiful outcomes on anterior teeth quickly &

easily? IF NOT, PRACTICE!

1

70

71

4/17/2020

36

Tooth Size Averages

2nd Premolar 1st Premolar Canine Lateral Incisor Central Incisor

6.6mm 7.1mm 7.6mm 6.6mm 8.6mm

7.7mm 8.6mm 10.6mm 9.8mm 11.2mm

Width

Length

0.6-1-1.68

Golden Proportion Measurement.

72

73

4/17/2020

37

SculptPad (Ivoclar)

• Practice Preparations

• Waxup

74

75

4/17/2020

38

ADDITIONAL TOOLS

◆ Panadent: Multi Purpose Ruler

◆ Erskine: Dentagauge 1 & 2

ADDITIONAL TOOLS

76

77

4/17/2020

39

What Records & WhenDiagnostic & Prep Reduction Models

Diagnostic Guides

78

79

4/17/2020

40

Diagnostic Guides

Veneer Preparations

80

81

4/17/2020

41

Three Shades of Mosaic

Three Shades of Mosaic

82

83

4/17/2020

42

No Prep Veneers• Do a waxup

• Duplicate into a stone model

• Over impression of stone model w/ PVS BEADLINE TECHNIQUE or Siltech Putty

• Intraoral mockup using the over impression filled with temporary acrylic**

• Is thickness and appearance okay?• Depth cuts through over impression if necessary.

• Typically no provisionals are necessary

• No undercuts

• Color change varies based on tooth position/color

Tooth Preparation Conservative Preparations

84

85

4/17/2020

43

Preparations86

87

4/17/2020

44

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins

• Retention Form (Line of Draw)

Images from Bruce Crispin, DDS, MS book entitled “Contemporary Restorative Dentistry”

88

89

4/17/2020

45

Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins



Veneer Preparations

• Depth Cuts

• Tooth Reduction

• Margins



90

91

4/17/2020

46

Veneer Preparations-Feldspathic Porcelain

Depth cuts of 0.2mm-0.8mm*

1.0mm-1.5mm incisal reduction*

Veneer Preparations-Pressed Ceramics

92

93

4/17/2020

47

Modern Ceramics

• Stand Alone Strength Properties

• Feldspathic (80-120 mpa)

• Lithium disilicates (360-500mpa)

• Lithium silicate (373 mpa)

• Zirconia (Monolithic 640-1200 mpa+)• Layered Zirconia Feldspathic (80-120mpa)

GC America Initial Lisi Veneering Ceramic for LisiPress (Lithium Disilicate)

94

95

4/17/2020

48

96

97

4/17/2020

49

Incisal edge preparations

a) No incisal lengthening

b) Changing color or wear

c) Lengthening tooth

d) Interproximal

a) When to break contact?

e) When to do a crown

Veneer Preparations


labial reduction options Depth Limiting Burs - Brasseler USA

Average enamel thickness

At CEJ .3-.4 mmMiddle third .8-1.0 mmIncisal third 1.1-1.3 mm

Veneer Preparations

98

99

4/17/2020

50

Preparation Reduction• Depth reduction burs

• Safe reduction

• Lasco

Veneer Preparations

Independent Depth Cuts (Lasco Burs)

▪ Depth Cuts▪ Tooth Reduction▪ Interproximal & Margins▪ Retention Form (Line of Draw)

100

101

4/17/2020

51

Preparation

Aesthetics

Function

Bonding to Enamel

Material Options

Minimal Prep Case: 2

Minimal Prep Case:

102

103

4/17/2020

52

Wax-up Case:

Preparation Guides:

104

105

4/17/2020

53

106

107

4/17/2020

54

Burs• Organization

• Diamonds

• Carbides

◼ K0096 Finishing Kit $126.47 each

◼ K0095 Preparation Kit

$125.47 each108

109

4/17/2020

55

• Photomed (818) 908-5369

110

111

4/17/2020

56

SHADE SELECTION

Shade Assumptions

BW, B1, B2, A1, A2

Provisional Techniques

-Free hand

-Beadline Provisionals

-Putty over impression of waxup

-Premade temps?

112

113

4/17/2020

57

114

115

4/17/2020

58

116

117

4/17/2020

59

118

119

4/17/2020

60

Review-Chief Complaint

-Occlusion

-Photographs/Imaging?

-Whiten first

-Waxup/BeadLine Provisional

-Material Selection

-Practice Preps

-Photograph Prep Shade

EMOTIONFocus on overall appearance

Stay away from little details

“Going to look & feel great”

120

121

4/17/2020

61

Minimally Invasive Veneers…. Why? Benefits??

Waxup

Mockup

Preparation

Provisional

Bonding to Enamel

Material Options

Minimal Prep Case: 3

Beadline Provisional Mockup

122

123

4/17/2020

62

Mockup

Depth Cuts

124

125

4/17/2020

63

Photos for Laboratory Technician

Provisional Restorations

126

127

4/17/2020

64

Final Restorations

Provisionals Mimic The Final Restorations

128

129

4/17/2020

65

LuxaTemp Ultra (DMG)

130

131

4/17/2020

66

132

133

4/17/2020

67

Remember The Old Appointment Book?

How LONG Did It Take To Answer A Question About Balances, Forgotten

Appointments?

134

135

4/17/2020

68

Patients..

• Attention Spans Have Dropped

• People Want Immediate Gratification/Results

• Post Cards, Mailers, Yellow Page Ads, Commercials…..are dying.

• Who are you?

• Why you?

• What do you offer?

• EMOTION…

136

137

4/17/2020

69

415-969-7695

138

139

4/17/2020

70

•EVERY new patient

•Post-op Follow-up

•Pre-op Information

5 Minute Plan

140

141

4/17/2020

71




5 Minute Plan




5 Minute Plan

142

143

4/17/2020

72

TIP

144

145

4/17/2020

73

146

147

4/17/2020

74

Fast & Convenient

Keep payment data off your network

80% growth from 2015 -

Why Mobile Payments

148

153

4/17/2020

75

John Doe

Invoice

1.Attach

Invoice

154

155

4/17/2020

76

156

157

4/17/2020

77

158

159

4/17/2020

78

160

161

4/17/2020

79

Complex Positioning &

Gingival Tissues: #8Aesthetics

Tissue Problems

Poor Function

No TMJ Problems

162

163

4/17/2020

80

Incisal position

Gum height

164

165

4/17/2020

81

2-4 mm

10-12 mm

166

167

4/17/2020

82

168

169

4/17/2020

83

170

171

4/17/2020

84

172

173

4/17/2020

85

Instant Ortho/Un-Rotating Teeth

• Do initial workup

• Diagnostic preps

• Diagnostic waxup


◼ Sequence

– Reduce all excess tooth structure

– Ideal reduction

– Margin placement

174

175

4/17/2020

86

176

177

4/17/2020

87

178

179

4/17/2020

88

Cementation**

180

181

4/17/2020

89

• Bioactive material

• affinity to tooth structure. when placing a glass ionomer a weak acid or conditioner is used to aid in releasing calcium and phosphate ions from the tooth structure. These calcium and phosphate ions combine into the surface layer of the glass ionomer and form an intermediate layer called the interdiffusion zone. This bond layer can be very strong and significantly reduce the microleakage that would occur at the margins of the restoration.

• Very good fluoride and ion release helps remineralize tooth structure in the remineralization–demineralization process that naturally occurs in the oral cavity.

• They chemically bond to enamel and dentin.

Why Glass Ionomers?

182

183

4/17/2020

90

• They produce good marginal integrity.

• They shrink only one ninth the amount of composite material.

• They are fluoride-rechargeable.

• There are no free monomers in the material.

• The cavity preparation can be bulk-filled, making the materials easy to place.

• They exhibit excellent biocompatibility.

Why Glass Ionomers?

GLASS IONOMER SANDWICH

•Class I, II, III & V posterior

restorations

•Open & Closed Sandwich

techniques

•Composite replacement

•Amalgam replacement

•High caries risk patients

•Pediatric patients

•Geriatric patients

•Special needs patients

•Long term resistance to

microleakage

184

185

4/17/2020

91

RESIN TO DENTIN HYBRID ZONE

186

187

4/17/2020

92

GLASS IONOMER INTERFACEIn

terfa

ce

An

aly

sis (TEM

)

CARDOSO et al. J Dent 2010

When dentin is missing, use conventional glass ionomers to replace it. It is the best dental material available today that virtually mimics dentin. No adhesive is required, and sensitivity is non-existent. Like dentin, conventional glass ionomers have a very high compressive strength, ensuring it will withstand long term mastication forces.

188

189

4/17/2020

93

GLASS IONOMER MATERIALS• Dentsply-ChemFil Rock Restorative

• SDI-Riva LC, light cure HV, Riva SC, self cure HV

• G.C. America-Fuji II LC, Equia Fil (Fuji IX)

• VOCO-Ionolux, Ionofil Molar AC

• 3M/ESPE-Ketac Nano, Photac Fil Quick, Vitremer, Ketac Molar Quick, Ketac Fil Plus

• Shofu- FX II

Microleakage and missing fillings from high occlusal loads on teeth can cause large cervical stress concentrations resulting in disruption of the bonds between the hydroxyapatite crystals and the eventual loss of cervical enamel and dentin.

190

191

http://www.chemfilrock.com/node/51/lightbox2

4/17/2020

94

ABFRACTION LESIONS & CLASS V RESTORATIONS

LATIN WORDS, AB – “AWAY”, FRACTION – “BREAKING”

• Pathological loss of tooth structure caused by biomechanical loading forces.

• Static and cyclic flexural overloading of tooth structure ultimately leading to fatigue and failure of tooth structure away from the point of loading.

RESIN MODIFIED GLASS IONOMERS (RMGI)• Light cured

• Dual cured

• High flexural strength

• Lower compressive strength than conventional G.I.

• Good polishability

• Excellent wear

• Hydrophillic

• Fluoride release

• No microleakage

• No adhesives

• Acid resistant layer

• Reduces sensitivity

• True chemical adhesion

192

193

4/17/2020

95

GC FUJI AUTOMIX LC

RESIN MODIFIED GLASS IONOMER RESTORATIONPost-Op Photo – notice unlike typical class V composite RMGI restorative material.

194

195

4/17/2020

96

Typical treatment involves the placement of a #00 retraction cord on each tooth followed by a shade selection. Roughen tooth structure with air abrasion. Place cavity conditioner on all areas to be restored for 10 seconds, then wash and dry.

Restorative Therapy- Case

Mix RMGI and syringe into place. Utilize hand instruments to shape and remove gross excess. Cure each tooth for 20 seconds. Remove excess and contour using a handpiece with fine diamond burs. Teeth should be isolated from saliva.


196

197

4/17/2020

97

After contouring the restorations can be coated with a self etch adhesive coating, and cure for 10 seconds.


Eleven year post-op photos show the integrity of the material is still

excellent. Note the lack of marginal microleakage stain often

present with composite restorations.


198

199

4/17/2020

98

G-AENIAL BULK INJECTABLE –

AVAILABLE SHADES

A1 & A2 shades available

200

201

4/17/2020

99

• Injectable high strength nanoparticle composite with ideal viscosity handling and adaption characteristics that may be used as a one step application for bulk filling up to the occlusal surface without the need for capping or veneering with another composite

• Perfect for Class III defects under veneers.

G-AENIAL BULK INJECTABLE

202

203

4/17/2020

100

204

205

4/17/2020

101

WEAR RESISTANCE

Selection Process

◦ Open Bite Trays

Plastic-full or quadrant

Metal-full or quadrant

Custom Trays

Non-perforated or perforated (metal or plastic)

Rigidity can eliminate tray distortion and rebound

Spring back after impression is possible with plastic

Cross arch stabilization

Ideal occlusal stops for proper model articulation

Able to recreate excursive movements if mounted on a

semi or fully adjustable articulator.

Potential for errors & adjustments are low

Impression Trays

206

208

4/17/2020

102

Custom trays create more

ideal placement

Thinner material creates

less distortion

USE TRAY ADHESIVES for

all open bite trays, not just

custom trays.

Only negative is time

Impression Trays Selection Process

Custom Tray

209

210

4/17/2020

103

▪ 4 upper & lower trays

▪ 60 sec. @ 158°F

▪ Fast, efficient

▪ Virtually custom

▪ 30% less impression

material used

Impression Trays

HeatWave by Clinician’s Choice

211

212

4/17/2020

104

213

214

4/17/2020

105

215

216

4/17/2020

106

Impression Trays


Impression Trays


217

218

4/17/2020

107

Dry all teeth in arch

Place tip in most difficult area first

Keep tip on margin and immersed in material

Go around entire margin first

Next go to adjacent teeth

Then do coronal aspect of teeth

Double Mix Single Impression is the most accurate

Syringe Placement

219

220

4/17/2020

108

Simplified Provisionals**

Siltech Putty Matrix

Bead Line Veneer Provisional Restorations. Pract Proced Aesthet Dent 2009;21(3):E1-E7.

Duplicate waxup model in stone

Scribe a 0.5-1mm line with a sharp instrument into the

model where the tissue and tooth come together.

Provisionals (Bead Line Technique)

221

222

4/17/2020

109

Duplicate model with a fast setting polyvinyl impression material.

I have used light and medium body washes with a heavy body tray

material.



The scribed line creates the Bead Line in the over impression of the cast.

223

224

4/17/2020

110

The Bead Line in the over impression creates pressure along the tissue

and preparation margin. This causes a thin cut or separation of the

acrylic flash from the provisionals for easier clean up.


Typically the excess acrylic can be removed with fingers, a spoon or discoid instrument. Minimal

to no effort is required to remove excess flash. If a void or a margin is exposed simply fill the

void with a flowable. Etching and a bonding agent are not required as the flowable will adhere to

the air inhibition layer of the temporary acrylic and you do not want to adhere to the tooth.


225

226

4/17/2020

111

The Bead Line Provisional Technique creates less work and risk of damaging tissues and tooth

structure. Typically the process takes 5-10 minutes to make provisionals. Consepsis (Ultradent)

can be placed on the teeth and dried prior to fabricating provisionals.


-Visalys (Kettenbach)

-TempSmart (GC America)

-Inspire (Clinician’s Choice)

-ExperTemp (Ultradent)

-Luxatemp Ultra (DMG)

Provisionals

227

228

4/17/2020

112

Cling 2 (Clinician’s Choice) for all my full crowns & bridges,

retentive inlays & onlays.

My Favorite Temporary Cements

ClearTemp LC (Ultradent)

For either veneers or thin

anterior cosmetic restorations

229

230

4/17/2020

113

-Aesthetics

-Function

-Gingival Embrasures

-Excess cement

-Patient homework & questions

Post-Op Check

From Imaging & Diagnostic Wax-up the entire case was duplicated

231

232

4/17/2020

114

Impressions & Provisional Tips

233

234

4/17/2020

115

235

236

4/17/2020

116

25% aluminum sulfate (will not oxidize & turn black)

25% aluminum chloride

Ultradent ViscoStat Clear

Heat Wave custom tray & Affinity impression

237

238

4/17/2020

117

Inspire Bead Line Provisionals

239

240

4/17/2020

118

Another Case Of The Week

241

243

4/17/2020

119

Provisionals (Temp Tray, Template) Clinician’s Choice

• Utilize an accurate preliminary over impression

• Maintain over impression

• Template 30s working time / 30s setting time


244

245

4/17/2020

120

▪ Heat Wave Thermoplastic

Tray

▪ #00 Record

▪ Tissue Goo if necessary

▪ Bite Registration

▪ Photograph

▪ Inspire Temporary

▪ Cling 2 Temp Cement


Utilize an accurate preliminary over impression

Maintain over impression

Check contacts and occlusion

Place temp cement only on margins

Do not fill temp with cement

Or vent holes

246

247

4/17/2020

121

Photography to check color match

248

249

4/17/2020

122

REVIEW

• Full arch impression Heat Wave Tray

• Record or Diode laser

• Light & Heavy Body Impression Material (Affinity)

• Bead Line Provisional Technique (Inspire) uses no temp cement or

adhesives, mechanical retention, shrink wrapped (using Template)

Simplified Provisionals**

Siltech Putty Matrix

250

251

4/17/2020

123

Bead Line Veneer Provisional Restorations. Pract Proced Aesthet Dent 2009;21(3):E1-E7.

Cosmetic Provisionals (Bead Line Technique)


Scribe a 0.5mm-1mm groove into tissue & a little on tooth

252

253


4/17/2020

124



254

255

4/17/2020

125


No Polish Necessary if you use a good model


256

257

4/17/2020

126



258

259

4/17/2020

127

Case #4: Single Tooth Aesthetics

Veneers

Function

Gingival Bonding

260

261

4/17/2020

128

Remove old restorations & repair abfraction lesions on cervicals

• Stump Shade (dehydration factor)

Base Shade

262

263

4/17/2020

129

Impressions

Facebow & Wax Bite Registration

264

265

4/17/2020

130

Provisionals

Free Hand Provisionals

266

267

4/17/2020

131

Free Hand Provisionals Example

• Materials

• Rigid Bite Registration

• Light and Heavy Body

Prefabricated Over Impression

268

269

4/17/2020

132

AESTHETIC RESIN TEMPORARY CEMENTS

• Materials

• Bifix Temp-VOCO

• TempBond Clear-Kerr

• ClearTemp LC-Ultradent

Before & After Photos

270

271

4/17/2020

133

Mixed Provisionals

272

273

4/17/2020

134

274

275

4/17/2020

135

276

277

4/17/2020

136

Waxup, Reduction Guides &

Temporaries (Case 6)

278

279

4/17/2020

137

280

281

4/17/2020

138

282

283

4/17/2020

139

Preparation Guides

Preparation Guides

A-TYPE PREP

284

285

4/17/2020

140

286

287

4/17/2020

141

288

289

4/17/2020

142

Removing provisionals that are locked on.

Removing provisionals that are locked on.

290

291

4/17/2020

143

292

293

4/17/2020

144

Nine Years Later

QUESTIONS?

Aesthetic Contouring (LASERS & IMPRESSIONS

294

295

4/17/2020

145

Aesthetic Contouring

Time??

ROI??

Aesthetic Contouring & ExperTemp Provisional

296

297

4/17/2020

146

AMD Picasso Laser Tissue re-contouring

298

299

4/17/2020

147

ADHESION

RESTORATION PLACEMENT?

• Bonded

• Margin placement

• Moisture Control

• Technique Sensitive

• Materials

• Self Adhesives

• Bonding agent (TE or SE) & luting resin

• Cemented

• Margin placement

• Moisture Tolerant

• Retention Required

• Materials

• RMGI

• Ceramir

Cement Selection

300

301

4/17/2020

148

RESIN CEMENT COSMETIC CASES….

COSMETIC CASES….

302

303

4/17/2020

149

COSMETIC CASES….

COSMETIC CASES….

304

305

4/17/2020

150

COSMETIC CASES….

COSMETIC CASES….

306

307

4/17/2020

151

COSMETIC CASES….

COSMETIC CASES….

308

309

4/17/2020

152

COSMETIC CASES….

COSMETIC CASES….

310

311

4/17/2020

153

PROVISONALS

PROVISIONALS

312

313

4/17/2020

154

CERAMIC TRY-IN

• Make sure it is etched properly from lab

• Ceramic Primer prior to try-in (unless using Ceramir)

• Ultrasonic with ethanol after try-in

Silanes

Universal Adhesives (w/MDP)

Silane Primer + MDP

Organo-Phosphate Monomer (MDP)

Silane Primers

314

315

4/17/2020

155

TRYIN APPROVAL

316

317

4/17/2020

156

SELECT HV ETCH IS A 35% HIGH VISCOSITY PHOSPHORIC ACID

ETCHANT AVAILABLE WITH BENZALKONIUM CHLORIDE (BAC) AND

IS DESIGNED FOR PIN-POINT ACCURACY.

318

319

4/17/2020

157

• Light-Cured Dental Adhesive

All-Bond Universal is a universal adhesive it can be used with direct and indirect restorations and is

formulated to be compatible with light-, dual- and self-cured materials. The versatility of All-Bond

Universal makes it an indispensable part of any dental practice.

• Unique Benefits:

• Not moisture sensitive use on wet, dry or moist tooth structure

• Impressive bond strength to ALL substrates

• Use with ALL direct and indirect restorations (<10 micron thickness)

• Ideal chemical balance for both total- and self-etch adhesion from one bottle

• Compatible with ALL resin cements (no additional activator required)

• Virtually no post-operative sensitivity

• Clinical Significance:

• All-Bond Universal offers the flexibility for total-, self- and selective-etch procedures

• All-Bond Universal is compatible with all light-, self- and dual-cured resin composite and cement

materials for all direct and indirect procedures

• All-Bond Universal works with dual cure resins, NO activator is required

320

321

4/17/2020

158

322

323

4/17/2020

159

324

325

4/17/2020

160

3 VITA® shades

2 chromatic shades

Choice 2 Veneer Cement- light-cured luting cement designed specifically for cementation of porcelain and composite veneers. - Choice 2 exhibits color stability which is a critical factor in esthetic veneer cementation. A range of VITA®*

shades as well as chromatic shades are available allowing for flexibility to achieve high esthetics. - Corresponding try-in pastes are available for shade confirmation prior to final cementation.Unique Benefits:•Choice 2 is specifically formulated for color stability (Delta E <1.2**) resulting in high esthetics•Excellent physical properties ensure the restoration will stand up to significant pressure and stress that is placed on veneers daily•Highly filled resin cement enhances the overall strength of the restoration•Low film thickness ensures veneers are completely seated•Corresponding try-in pastes confirm shade selection prior to cementationClinical Significance:•Choice 2 cement will not change (shade shift) over time, a problem that can occur with dual-cured systems•A multitude of shades ensures that the final restoration blends well and is natural looking for any patient

326

327

4/17/2020

161

LITHIUM DISILICATE & SILICATE, LEUCITE AND FELDSPATHIC

RESTORATIONS

IS AN ADHESIVE CEMENTATION

SYSTEM THAT IS EASY-TO-USE,

EFFICIENT AND HIGHLY

EFFECTIVE

328

329

4/17/2020

162

FINAL RESTORATIONS

330

331

4/17/2020

163

Veneer Finishing System

Send CONTACEZ to 24587 to request a sample.Using the code SNYDER20 on their website will get attendees 20% off their next order!

ContacEZ Restorative strip system

• NEW Gold Narrow Strip 0.10mm single sided medium diamond grit Sub Gingival Trimmer w/ Blank Clear Gateway

• Black Diamond Strip 0.06mm fine diamond single sided

• Orange Serrated Diamond Strip 0.05mm extra fine diamond single sided

• White Serrated Strip 0.035mm

• Blue Serrated Strip 0.065mm

• Gray Final Polishing Strip 0.05mm ultra fine diamond single sided

332

333

4/17/2020

164

ContacEZ IPR Optional Strips

• Clear IPF Single Sided Opener 0.10mm med-fine diamond

• Cyan IPR Single Sided Widener 0.12mm med-coarse diamond

• Purple IPR Super Widener 0.25mm

coarse diamond

• Brown IPR Mega Widener 0.30mm coarse diamond

334

376

4/17/2020

165

• Reduce Your Stress & Build A Better Life

• Better Business & Communication Skills

• Incredible Marketing & Advertising

• Front Office Simplification

• Office Metrics/KPI

• Responsive Websites, Social Media

• Enhance Diagnostic Skills & Procedures

• Photography

• Elective Dentistry

• Cosmetic & Restorative Dentistry

• New Materials, Techniques, Technology & more..

Online Training For Dentists.www.LEGIONpride.com

Questions?

377

378

4/17/2020

166

TODD [email protected]

379

http://www.instagram.com/Toddsnyderdds/

http://www.facebook.com/todd.snyder.dds

http://twitter.com/tcsaesthetics

http://www.instagram.com/Toddsnyder1/

TODD C. SNYDER, DDS, FAACD The Nuts & Bolts of Veneers · 2020-04-17 · Provides bridge to clinical evaluation and presentation of options Creates EMOTION and DESIRE ... GC America

Documents