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In dentistry, a veneer is a thin layer of material placed over a tooth, either to improve the aesthetics of a tooth or to protect the tooth's surface from damage. 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.
Veneers were invented by California dentist Charles Pincus in 1928 to be used for a film shoot for temporarily changing the appearance of actors' teeth. Later, in 1937 he fabricated acrylic veneers to be retained by denture adhesive, which were only cemented temporarily because there was very little adhesion. The introduction of etching in 1959 by Buonocore2 aimed to follow a line of investigation of bonding porcelain veneers to etched enamel. Research in 1982 by Simonsen and Calamia 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 in an article describing a technique for fabrication, and placement of Etched Bonded Porcelain Veneers using a refractory model technique and Horn describing a platinum foil technique for veneer fabrication. Additional articles have proven the long-term reliability of this technique.
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.
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. Dentists also recommend using thin porcelain veneers to strengthen worn teeth. It is also applied to yellow teeth that won't whiten. Thin veneers is an effective option for aging patients with worn dentition. In many cases, minimal to no tooth preparation is needed when using porcelain veneers.
Michael Zuk, D.D.S. profiles the problem of overuse of porcelain veneers by certain cosmetic dentists in 'Confessions of a Former Cosmetic Dentist'. He suggests that the use of veneers for 'instant orthodontics' or simulated straightening of the teeth is harmful, especially for younger people with healthy teeth. Leading dentists caution that minor cosmetic or wear is not justification for porcelain or ceramic veneers, the tooth preparation of which may destroy 3–30% of the tooth surface during tooth preparation for veneers, and after 10 years, 50% of veneers are gone, need retreatment, or are no longer in satisfactory condition.
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 possibilities: crown, composite resin bonding, cosmetic contouring or orthodontics.
Non-permanent dental veneers are available. These dental veneers are moulded to existing teeth, are removable and reusable and are made from a flexible resin material. Do-it-yourself kits are 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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- Pincus CL."Building mouth personality" A paper presented at: California State Dental Association;1937:San Jose, California
- Simonsen R.J. and Calamia John R. "Tensile Bond Strengths of Etched Porcelain", Journal of Dental Research, Vol. 62, March 1983, Abstract #1099.
- Calamia John R. "Etched Porcelain Facial Veneers: A New Treatment Modality Based on Scientific and Clinical Evidence", New York Journal of Dentistry, Vol. 53, #6, Sept./Oct. 1983, pp.255-259.
- Horn HR. "A new lamination, porcelain bonded to enamel". NY St Dent J 1983;49(6):401-403
- Calamia John R. and Simonsen R.J. "Effect of Coupling Agents on Bond Strength of Etched Porcelain", Journal of Dental Research, Vol. 63, March 1984, Abstract #79.
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- Leading dentists question widespread use of porcelain crowns and veneers Leading dentists question widespread use of porcelain crowns and veneers