I’ll talk about how things have changed for me, as I haven’t felt the need to investigate all the various fads that have come and gone; nor can I comment on how veneers may have changed for other dentists.
With a handful of standard digital photos, I can readily evaluate your smile collaboratively with you – this will help you see details far more readily and dispassionately. I can email these photos to the ceramics artist to assist with laboratory work that accurately reflects what we plan and specify. Fine details of shade, opacity / translucency and subtle optical nuances can be studied close-up, so that, where desired, a veneer or crown can accurately mimic its neighbour. All this was possible before digital photography but with much less convenience – and something that is not convenient is less likely to happen.
For several years now we have had a material called lithium disilicate – trade name e.max – which is much stronger than previous fully bondable ceramics without any noticeable deficit in beauty. Unlike many other ceramics used for veneers, a reasonable degree of masking can be built in to thid material, increasing the number of situations in which tooth-conserving veneers can still be used to mask relatively dark, discoloured teeth. The increased strength of lithium disilicate has two benefits: longevity of function, and ease of handling by the dentist and assistant. Previously, although veneers were strong once bonded to the tooth, they were delicate to handle, being often only .3mm to .5mm thick. This propensity to break if mis-handled could be intimidating to the dentist and assistant, and a major inconvenience to all involved. I can’t remember ever having broken an e.max / lithium disilicate veneer before bonding!
IMPROVED BONDING CEMENTS
Bonding cement – the glue that holds a veneer powerfully to the tooth – has been developed to the point where we can “try in” a veneer that has already been surface-treated in readiness for bonding, and we can use a trial cement that is accurately matched for colour and translucency and is chemically and optically almost identical to the final cement (other than for the ability to set hard under exposure to the dental curing light). Once the try-in procedure has been successfully completed, the trial cement can just be wiped off in readiness for placement of the final cement. This saves me a huge amount of time; and if it saves me time, it saves my patient time in the chair. Anything that makes for an easier and quicker process is beneficial to all concerned.
PLACEMENT AND FINISHING
Finally, with ideas from visiting overseas lecturers – as well as tricks I’ve worked out for myself, helped by a super-intense hardening light – the veneer cementation process has become faster and easier.