Smiles By Design: Perfecting Veneers

Smiles By Design: Perfecting Veneers

PLANNING FOR SUCCESS

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

Written by Andrew Sedler, COO

A person’s smile is most often one of the first features noticed by someone, whether it has beautiful white teeth, or needs some help. There is no better way to improve a smile than with porcelain veneers.

Burbank Dental Lab has played a key role in the fabrication of thousands of veneers over the years and has experienced the life-changing impact that dental veneers can have on a person's overall appearance. The emotional impact of these cases is directly linked to the patient experience. The Smiles By Design team at Burbank Dental Lab was created to help manage cosmetic cases to ensure the patient has an exceptional experience throughout the process.

The Smiles By Design Team

The Smiles By Design team at Burbank Dental Lab consists of highly skilled technicians who are required to complete hundreds of hours of advanced continuing education. Their training includes occlusion principles, internal color characterization, and advanced tooth morphology.

Planning for Success

The key to success in these cases is in the communication between the dentist, patient, and lab. The patient's desires and concerns must be clearly understood and communicated, and a plan formulated.

Case planning ensures that all of the information necessary to create restorations that fulfill what the patient envisioned are gathered and implemented.

The Smiles By Design team brings a step-by-step approach to providing the necessary support to the clinician, from planning to insertion.

Dental Veneer Case

Burbank Dental Lab is very fortunate to work with outstanding clinicians such as Dr. Mike Wygant, who worked with our Smiles by Design team on the following 8 unit veneer case.

The following systematic approach was used to provide the patient with the smile she envisioned.

Smiles By Design: Perfecting Veneers

The patient's main complaint was that she had chipped her central. She had the central repaired with bonding several times, but this tooth repeatedly chipped in the same area. In addition, she had flattened and ground her teeth (see the image shown above).

It was clear that this patient would see great improvement to her smile by restoring the eight anterior teeth from 5-12.  This would improve the cracked, chipped, and worn down teeth as well as providing her with a more permanent solution than the old bonding that was not working.

Wax Up

Once an initial plan is determined, it is always advised that the wax-up be completed prior to the final restorations. This allows the technicians to mock up the case according to the initial plans and patient desires. It allows the lab to discover any possible limitations, but more importantly, it will give the patient the opportunity to try the proposed treatment prior to the fabrication of the final restorations.

Both the patient's maxillary and mandibular arches were scanned with an intra-oral scanner. In addition, the patient's bite was captured digitally, and this data was uploaded to Burbank Dental Labs’ digital portal.

Digital scans require the following:

  • Scan both the upper and lower arch.
  • Scan the bite for proper occlusion.
  • Rotate the digital scanning wand at least 4-5 mm to ensure adequate gingival tissue is captured.
  • Check to make sure all of the relevant data has been adequately captured before sending in the file.

The data was downloaded to Burbank Dental Lab’s Exocad software. A digital wax-up was designed encompassing Dr. Wygant’s directions (see above image).

The digital wax-up was sent to a 3D printer where it was printed. To help design the wax-up, the following steps were done by the Smiles by Design team:

  • The prescription was evaluated to ensure Dr. Wygant’s requirements were fully understood.
  • The patient's existing oral situation was evaluated, including any function or occlusion issues.
  • The provided intraoral images were reviewed.
  • The desired outcome was digitally created and printed on a 3D printer.
  • The best material option to achieve the desired results was evaluated.

 

Temporization

The printed models were presented to the patient for evaluation. Dr. Wygant created a putty matrix to create temporaries of the proposed case that the patient could wear and evaluate.

This step is the most critical in the process. The patient can test drive the veneers and get feedback from friends and family.  With this process, the patient will know exactly what to expect in the final restorations.

The patient wore the temps for one week and then provided feedback to use in the final restorations. Most of her requests were minor and easy to implement.

Final Restorations

Dr. Wygant used PVS impressions for the final e.max restorations. These were sent to Burbank Dental Lab along with preop photos and detailed instructions to aid in creating the final restorations.

Using the bites provided, the case was mounted. The fabrication process then began, where quality control was implemented at each step.  Under magnification, the case was evaluated to ensure the fit, shade, and overall plan were incorporated in the case, as shown below.

The patient was thrilled with the final results, as shown below.

Smiles By Design Workflow

The ideal workflow to ensure a cosmetic case that will exceed patient expectations begins with the end result in mind. This process works best if the  Smiles by Design team at Burbank Dental Lab is included in the process from the start.

An ideal workflow for a case like this will require the following:

  • Study or preop models
  • Patient photographs
  • A clear understanding of the patient's desires
  • Diagnostic wax-up
  • Preparation
  • Impressions or digital scans
  • Bite records including a face-bow
  • Temporaries
  • Patient feedback after wearing the temporaries
  • Photos of the temporaries
  • Fabrication of final restorations

Before and After

Through proper case planning, the end result is completely predictable. This predictability helps ensure patient satisfaction and helps to create raving fans of the dental practice. This knowledge was what led Burbank Dental to create the Smiles By Design team. The team helps to plan, anticipate problems and then create solutions that make cases like the one discussed here a success.

Burbank Dental Lab would like to thank Dr. Wygant for allowing us to work with him on this case and for providing the notes and photos for this article.

All On "X" Success Guide Coming Soon

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Fabrication
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Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.