What are laminate and veneer?
Laminate porcelain is a very thin ceramic material used especially on front teeth. It is usually preferred if your teeth are broken, eroded, overlaying, have a gap (“diastema”), or if you are unhappy with colour and shape of your teeth. Most important aspect of this method is filing out only 0.5 mm on front side of teeth for preparation. This means the porcelain shell is very thin and fragile. However, research has shown laminate porcelain is not separated from tooth even after suffering trauma.
Porcelain laminates are glued to teeth with a special technique called “modern adhesive technique”. How does such a thin and fragile piece of porcelain retain such strong composition? This is where science-technique-art trio takes charge. Laminate porcelain displays same physical properties when glued in place. This statement is only true when carving out teeth, taking measurements, laminate production and placement are all performed delicately, meticulously, and precisely. Otherwise, unpleasant results may be observed. Today’s laminate porcelain, adhesive and bonding techniques are the pinnacle of dental aesthetics.
Pre Assessment
This appointment is dedicated to listen and understand patient’s problems, needs, and expectations. Patient’s expectations are important, because surreal expectations may cause frustration. During this first appointment patient is also characteristically and psychologically evaluated as well. Tooth-jaw-face relations are observed while patient talks. Lips at rest and smile photos are taken in relaxed condition. Upper & lower jaw models are taken, tooth colour is registered. Full tooth and jw x-ray, called panoramic film, is requested from patient.
Treatment Options
Acquired data is evaluated and treatment options are suggested in this phase. Patient is informed about different treatment options and phases, as well as pricing information. Mouth models and photographs are assessed together with the patient, and final form to meet patient’s expectations is discussed. Modern technology enables displaying final form on computer screen.
Treatment Plan
This stage is when the most convenient treatment plan is finalized together with the patient. In fact, every dentist wishes to offer the best treatment plan possible to their patients, but certain issues (such as socio-economic limits of patients, cultural structure, etc.) may restrict them. At this level, dentist describes how the final form should look like after treatment and aesthetic intervention.
What are the advantages of laminate porcelain against other methods?
Laminate porcelain has two significant advantages:
- It fully imitates enamel. Tooth enamel absorbs light, does not reflect it. This is called translucency. It is the characteristic of enamel. Laminate porcelain also absorbs light like enamel, and feels like natural colour, tissue, and brightness of enamel.
Colour constancy. Other bonding materials change colour over time due to tea, coffee, and cigarette consumption. Laminate is basically a type of porcelain, which includes glass particles, therefore surface colour doesn’t change and stays smooth.
Who is eligible for laminate porcelain?
People who have…
- small dents, chips, or deformation on front teeth
- discoloured teeth, or if they are unhappy with the colour of their teeth
- spotted teeth due to tetracycline or extreme fluorine consumption
- discoloured teeth due to trauma or root canal treatment
- gap between front teeth
Disfigured front teeth - when patient rejects orthodontic treatment
First Appointment
This is when your dentist assesses your teeth for the first time. Firstly, all your jaw & face records, your pictures, upper & lower jaw models, current teeth colour, and panoramic film are taken. You describe what kind of changes you would like to see in your teeth. Your dentist may prepare a temporary prosthetic to give you an idea of what the final form will look like. In addition, modern computer technologies of today enable us to display final form in image processing software.
First Step Preparing the Tooth: Cutting Front Side of Tooth
You may be anesthetized at this phase if necessary. Primary goal is to trim as little as possible. While exact values depend on individual case, filing down is generally 0.5 mm to 2.0 mm thick. We also need to achieve laminate surface with equal thickness overall; filing will be performed with this purpose. In certain cases, teeth are placed quite backwards, deeming this trim operation unnecessary.
Taking Measurement
Laminate porcelain measurements are taken with very precise techniques and delicate measurement material. After taking these measurements, your models are prepared in the laboratory. Your dentist consults your technician at this phase. It will take 1 to 2 weeks for your laminates to be placed after measurements are taken.
Temporary
After your teeth are filed down, you will feel rough surfaces on front side. You may also feel ridged or cornered areas with your tongue. This procedure removes part of enamel, which may cause minor hot/cold sensitivity. To minimise any problem you may encounter, you will be provided with temporary laminates. It takes some time to produce these laminates made from composite material. They are not quite durable, and often break while being removed.
Your temporary laminates will provide an estimation of how your final laminates will look like.
Gluing Porcelain Laminates
Before permanently gluing your laminates, a final trial is performed to ensure everything is as it should be. Under certain circumstances, your dentist may need to make adjustments even when your laminates are in ideal condition.
True colour of porcelain laminates only show after fixing cement is applied. Laminates are really thin, and you will not be able to see final colour before they are glued in place with cement. Hence, your dentist will only be able to show you decided colour after laminates are fixed in place. You will notice it really is the colour you agreed on. Recently, water-soluble trial paste has been introduced, which makes it possible to see what the final colour will look like.
Gluing technique is different from other porcelain crowns. Teeth and laminates are prepared for gluing at the same time. Both are washed and dried. Front side of your tooth will be etched with phosphoric acid. This etching is at microscopic level, and helps adhesive to stick stronger onto tooth surface. Next, bonding is applied to glue the cement onto the tooth chemically.
While all of the above are applied, laminates go through a series of chemical processes. They are treated with silane (a chemical process), hydrofluoric acid, and porcelain bonding is applied. These are very delicate chemical processes that must be handled by professionals scrupulously. Here we simply describe the order of procedure.
After all these proceedings are completed, gluing cement is applied inside laminate to overbrim very slightly. All surfaces of tooth is exposed to a certain wavelength of light.
Your bite occlusion is checked one last time. Finishing touches are made.
How to take care of your laminate porcelain
Basically, we recommend brushing at least twice a day as your dentist described, and using floss. You should prefer fluoride toothpaste with no corrosive properties.
When you have laminate porcelain, you should not allow bacteria plaque accumulation on bottom part of the tooth closer to gum. You will have noticed that your dentist focuses on this area both in clinic and laboratory phases. You should also take utmost care to protect this area and brush it elaborately. Otherwise, any plaque accumulation around here may cause gum inflammation and even gum recession.
You should avoid extreme and strong forces, such as strong impact and nail biting; if you have a sports activity where you may be hit in the mouth, you must wear mouth protection. If you are grinding your teeth at night, you definitely must wear protective plates your dentist will provide.
Of course, you must see your dentist semi-annually and check whether any bacteria plaque has been forming.
Situations where laminate porcelain is not suitable;
- Unhealthy gum, which must be treated before laminate treatment.
- Major part of tooth is missing.
- Most of tooth enamel is missing. Bonding that glues laminates mostly cling onto enamel. If enamel is low or missing, fixing will become a problem.
- Teeth have been filed down before.
People who grind their teeth unwittingly in their sleep (bruxism) must definitely use night protector plate, otherwise they are not eligible for laminate porcelain.
