Ultraconservative Dentistry Using “No-Prep” Porcelain Veneers AACD Accreditation Case Type I: Six or More Indirect Restorations

Charles C. Cooper, DMD, AAACD

Adapted from the full article, which originally appeared in the AACD’s Journal of Cosmetic Dentistry Winter 2013 issue. For more information, visit www.AACD.com  ©2016 American Academy of Cosmetic Dentistry. All rights reserved.

Patients today often request cosmetic solutions that do not require any tooth reduction. These patients frequently are adamant about their desire to have cosmetic “makeovers” with no preparation of their teeth. With the interest in more conservative cosmetic solutions, the public is demanding the preservation of their natural tooth structure. Frequently, patients present with small teeth in the esthetic zone that only need additive-type dentistry completed. To increase tooth size and shape and to create a more attractive smile, “no-prep” veneers have become commonplace in many dental practices.

Preoperative portrait.

A desirable case requires tooth size discrepancies where additive dentistry can be the solution.

The patient, a 22-year-old man, wanted a cosmetic solution for his small front teeth.

Preoperative smile.

Preoperative 1:2 retracted view.

During his initial visit the patient underwent a full series of photographs.

Preoperative 1:1 retracted view. Preoperative occlusal view.

Diagnostic wax-up.

A diagnostic wax-up and the placement of a temporary “trial smile” allowed the patient to preview the potential outcome.

Trial smile; occlusion checked to confirm no interferences.

Facebow transfer.

Photographs, shades, facebow, and centric relation bites were taken and sent to the laboratory.

After inspection of the veneers and crown from the laboratory, the restorations were tried in using a glycerin gel to check the shade and fit.

Notice the increase in size and length of the new porcelain restorations.

Simultaneous try in of all porcelain restorations.

A water rinse was used to remove the traces of glycerin from the internal surface of the restorations.

Cleaning the inside of a veneer.

The patient was scheduled for a one-week postoperative check and to take final clinical photographs.

In the end, the patient and the doctor both benefit from the journey. The doctor benefits by knowing he or she has provided an extremely conservative treatment and the patient benefits from being able to smile with confidence.

Dr. Charles C. Cooper is an AACD Accredited Member and a graduate of the University of Mississippi School of Dentistry. He practices at the Atlanta Center for Cosmetic Dentistry, in Atlanta, Georgia.

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