| Veneer (dentistry) | |
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| Intervention | |
A veneer |
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| MeSH | D003801 |
In dentistry, a veneer is a thin layer of restorative material placed over a tooth surface, either to improve the aesthetics of a tooth, or to protect a damaged tooth surface. There are two main types of material used to fabricate a veneer, composite and dental porcelain. A composite veneer may be directly placed (built-up in the mouth), or indirectly fabricated by a dental technician in a dental laboratory, and later bonded to the tooth, typically using a resin cement such as Panavia. In contrast, a porcelain veneer may only be indirectly fabricated.
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Veneers were invented by a California dentist named Charles Pincus[1]. At the time, they fell off in a very short time as they were held on by denture adhesive. They were, however, useful for temporarily changing the appearance of actors' teeth.
Research started in 1982 by Simonsen and Calamia[2] revealed that porcelain could be etched with hydrofluoric acid, and bond strengths could be achieved between composite resins and porcelain that were predicted to be able to hold porcelain veneers on to the surface of a tooth permanently. This was confirmed by Calamia[3] in an article describing a technique for fabrication, and placement of Etched Bonded Porcelain Veneers using a refractory model technique and Horn[4] describing a platinum foil technique for veneer fabrication. Additional articles have proven the long-term reliability of this technique.[5][6][7][8][9][10][11][12][13]
Today, with improved cements and bonding agents, they typically last 10-30 years. They may have to be replaced in this time due to cracking, leaking, chipping, discoloration, decay, shrinkage of the gum line and damage from injury or tooth grinding. The cost of veneers can vary depending on the experience and location of the dentist. In the US, costs range anywhere from $1000 a tooth upwards to $3000 a tooth as of 2011. Porcelain veneers are more durable and less likely to stain than veneers made of composite[14].
Veneers are an important tool for the cosmetic dentist. A dentist may use one veneer to restore a single tooth that may have been fractured or discolored, or multiple teeth to create a "Hollywood" type of makeover. Many people have small teeth resulting in spaces that may not be easily closed by orthodontics. Some people have worn away the edges of their teeth resulting in a prematurely aged appearance, while others may have malpositioned teeth that appear crooked. Multiple veneers can close these spaces, lengthen teeth that have been shortened by wear, fill the black triangles between teeth caused by gum recession, provide a uniform color, shape, and symmetry, and make the teeth appear straight[15].
The problem of overuse of porcelain veneers by certain cosmetic dentists has been profiled in the book, Confessions of a Former Cosmetic Dentist. The author suggests that the use of veneers for 'instant orthodontics' or simulated straightening of the teeth is harmful, especially for younger people with healthy teeth. Many cosmetic dentists agree that porcelain veneers can be used improperly and can exploit patients[16]
In the past, the only way to correct dental imperfections was to cover the tooth with a crown. Today, in most cases there are several alternatives: crown, composite resin bonding, cosmetic contouring or orthodontics.
Non-permanent dental veneers are available. These dental veneers are molded to existing teeth and are removable and reusable and are made from a flexible resin material. Do it yourself at home kits are also available for the impression-taking process. Actual veneers are made in the lab and sent to the wearer through the mail.
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