For decades, dentists have sought to answer an elusive question: what makes the perfect veneer? It’s a question that prompts the asking of others. What material is best? How should dentists prepare the teeth prior to treatment?
The short answer is that teeth require a tailored approach. Dental veneers differ in terms of materials and preparation, and these variables are selected in line with the specific needs of the patient.
How then do different design elements influence the success of veneers? And what type of veneer is best suited to your teeth? In search of an answer to this debate, we sifted through the evidence and have presented our findings below.
What Are Dental Veneers?
Let’s start with a simple definition. Dental veneers are thin, tooth-coloured shells that are bonded to the front surface of the teeth for cosmetic purposes. Unlike dental implants, which replace teeth, veneers are placed over the tooth to improve its appearance.
A Brief History of Dental Veneers
Dental veneers have come a long way since the first porcelain veneers were manufactured in the late 1920s. At this point, dental veneers were temporary and could only hold in the mouth for short periods. They found use in film sets across Hollywood.
Development continued through the early to mid-twentieth century, and veneers became more widely accessible in the 1950s. However, the materials used were still poor. Difficulty to polish led to abrasion of the opposing dentition as well as frequent staining.
In 1975, laminate veneers were introduced as a superior alternative to the early materials. These veneers also had the advantage of better aesthetics and less chair time, and they were instrumental in the continued rise in popularity of veneers.
The critical moment, however, came in the 1980s with the development of new porcelain materials and the etching of enamel to improve the bonding between tooth and veneer. Veneers were now more durable and natural-looking, closer resembling the veneers we use today.
More recently, composite resin materials have progressed and now represent a genuine alternative to the traditionally favoured porcelain, though the properties of these materials still vary widely.
There are now more options than ever for patients when it comes to veneers. The effectiveness of veneers has also advanced, and they can be used for a variety of purposes such as fixing discolouration, straightening a crooked smile and correcting overcrowded teeth.
The Importance of Veneer Preparation
A crucial part of the treatment process is the etching of enamel before the application of the veneers. Tooth reduction helps veneers appear more natural and fit seamlessly with the rest of the teeth.
Each type of veneer material requires a specific preparation plan in terms of the targeted area of tooth reduction and the dimensions by which enamel is etched. This is key to ensuring optimal comfort, aesthetics and durability.
What Are the Different Preparation Methods for Dental Veneers?
The preparation methods used to perform veneer treatment can differ. Historically, there have been four main designs of teeth preparation:
- Window preparation. This method preserves the functional palatial and incisal surfaces of the tooth.
- Feather preparation. This method prepares the incisal edge of the tooth but preserves the incisal length.
- Bevel preparation. This method prepares the incisal edge of the tooth and reduces the length of the incisal edge slightly (0.5–1mm).
- Incisal overlap preparation. This method prepares the incisal edge of the tooth and reduces the length of the incisal edge (about 2mm) so the veneer is extended to the palatal aspect of the tooth.
The preparation method of choice will vary depending on the material of the veneer as well as the shape and size of your teeth. The decision is generally left to the discretion of the dentist.
What Are the Different Types of Dental Veneer Materials?
Regardless of the chosen material, veneers are designed to be thin, durable and stain-resistant. However, each material has unique properties and comes with its own set of pros and cons. Let’s take a look at the two main types of materials used with veneers.
1. Porcelain Veneers
Porcelain veneers are the most popular type of veneers, owing to their excellent durability and natural appearance. These veneers are relatively thin and can be matched to the colour of the teeth for optimal aesthetics. With proper care, porcelain veneers can last up to 15 years.
These are popular among patients who want to make small changes to their teeth or alter the tooth shape, size, and colour. However, the treatment can be expensive and it also requires some enamel to be permanently removed from the teeth in the process.
2. Composite Veneers
Composite veneers are considered a more convenient and cost-effective alternative to porcelain veneers. Less preparation work is required for these veneers and the dentist may be able to perform the procedure in a single visit.
Composite veneers may be the most affordable option available, but they’re also more likely to stain or chip. Significantly less durable than porcelain veneers, composite veneers have an average lifespan of about five to seven years.
The Role of Preparation Design in the Success of Veneers
Faultless preparation of teeth is key to ensuring veneers fit comfortably and last a long time. Studies have so far been unable to establish the best preparation design, but they have shed light on some interesting truths nonetheless.
Here are some useful insights into the role of preparation design in the success of dental veneers:
- Across all preparation designs, restricting tooth preparation to the enamel is critical for favourable bonding strength.
- Preserving the interproximal contact helps maintain more of the enamel and existing tooth structure, which in turn makes the cementation process easier.
- Limiting preparation to a butt-join finish line is more sensible than having a chamfer finish line.
- Preserving incisal coverage seems to yield better results in terms of aesthetics and durability.
In most cases, the effects of choosing one preparation design over another are negligible. With no clear industry standard, the decision of preparation design is mainly left to the dentist’s preference.
The Role of Material Type in the Success of Veneers
The influence of material type on the success of dental veneers is far more clearcut than preparation design. Research shows that the material you choose to use with your veneers will have a significant impact on durability, aesthetics and your overall satisfaction.
There’s no doubt that porcelain veneers are more durable than their composite counterparts. Several studies into the matter have been performed, with researchers noting the strong adhesion complex between porcelain and enamel.
It’s been reported that the bonding strength of porcelain and enamel is 63 MPa, which is more than twice that of composite and enamel at 31 MPa. These findings provide quantitative evidence for the claim that porcelain veneers last longer than composite ones.
Porcelain and composite veneers can both be custom-designed to fit the exact colour of the surrounding teeth. As such, aesthetic quality should be judged over time as veneers begin to lose their initial sparkle.
This is where composite veneers fall short. Though these veneers provide a good initial aesthetic, studies show that they’re more prone to discolouration and wear. Porcelain veneers, however, offer predictable aesthetic results.
Patient satisfaction is subjective and therefore hard to measure. However, it’s generally determined by the same factors. These include the cost of treatment, the amount of preparation required for the material type and the longevity of the results.
Patient satisfaction, then, is the alignment between the patient’s expectations and the results. For patients looking for long-lasting veneers at any price, porcelain veneers are likely to yield the most satisfaction.
However, if the patient wants to limit their spending and the amount of tooth preparation required for treatment, there’s every chance that composite veneers will prove the most satisfactory option.
So, What Veneers Are Best For You?
We’ve covered a lot of ground, so let’s take a moment to summarise our findings. Firstly, the influence of preparation design on the success of veneers is limited. Your dentist should be left to select the most appropriate method based on the size and shape of your teeth.
With veneer materials, however, it’s a different story. Porcelain veneers provide long-lasting aesthetic results, while composite veneers are cheaper and generally less invasive. This means they require less preparation and do less permanent damage to your teeth.
Ultimately, the best type of veneers for you will be those that most closely match your needs. If money isn’t an issue and you want long-lasting results, go with porcelain. Composite veneers can be the treatment of choice for patients who prefer minimally invasive approaches.