Minimally Invasive Veneers for Minor Esthetic Corrections

Porcelain veneers can be an excellent minimally invasive solution for enhancing dental esthetics, particularly in cases involving intrinsic discoloration, minor misalignment, or anomalies in the shape or size of anterior teeth.¹ Due to the thinness and translucency of porcelain veneers, the resin cement selected to place them can influence their long-term success in terms of both durability and appearance. In such cases, it is important to select a cement that not only offers an appropriate shade match but also demonstrates optical integrity and resistance to long-term color change to support excellent esthetic results that are stable over time. When paired with appropriately matched ceramics, this can contribute to a seamless transition between restorations and natural dentition.

Case Report

A 32-year-old male patient presented with diastemas between teeth Nos. 7 through 10. In addition, tooth No. 8, which had previously undergone endodontic treatment, demonstrated discoloration (Figure 1). A conservative esthetic approach to address these concerns using porcelain veneers was presented to the patient, and he agreed to proceed with treatment.

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At the first appointment, teeth Nos. 7 thorough 10 were conservatively prepared for veneers (Figure 2). The preparations were then scanned (PrimeScan®, Dentsply Sirona), and all of the information was sent to the laboratory (PEAK Dental Studio, Pleasant Grove, Utah) with instructions to fabricate lithium disilicate (IPS e.max®, Ivoclar) veneers based on the wax-up design. Provisional restorations were placed, and the patient was dismissed.

At the delivery appointment, the provisional restorations were removed, and the preparations were cleaned with pumice and a liquid desensitizer (Hemaseal & Cide®, Advantage Dental Products). Because the laboratory had been instructed to hydrofluoric acid etch the intaglio surfaces of the veneers as specified by the manufacturer’s instructions, they did not need to be etched before try-in. The veneers were tried in using a try-in paste that corresponded with the shade of veneer cement selected (Choice™ 2 Veneer Cement [Translucent], BISCO) to simulate the final shade (Figure 3). The patient approved the esthetics.

Following try-in, the veneers were decontaminated using an air/water spray, and then a restoration cleaner (ZirClean®, BISCO) was used to remove any organic residue. After rinsing and drying, the intaglio surfaces of the veneers were silanated (Bis-Silane™, BISCO) (Image 4). Teeth Nos. 7 through 10 were then isolated using orthodontic retractors, etched with phosphoric acid (Select HV® Etch, BISCO), rinsed, and air-dried (Figure 5). Once the preparations were etched, a bonding agent (All-Bond Universal®, BISCO) was applied.^2,3 The veneers were then loaded with a light-cure, resin-based cement (Choice™ 2 Veneer Cement [Translucent], BISCO) and seated simultaneously. This cement was selected for this case because it is engineered with an amine-free chemistry that enhances color stability over time. The absence of chemical initiators associated with discoloration makes it ideal for veneers fabricated from translucent ceramic materials. In addition, its minimal film thickness (< 35 microns) enables superior marginal adaptation and provides it with excellent handling characteristics. Its viscosity facilitates controlled placement as well as straightforward removal of excess cement following an initial tack-cure.

After simultaneous delivery, each veneer was light cured facially for 3 to 5 seconds to tack-cure it into place (Figure 6). The excess cement was then removed with cotton rolls, rubber tips, and brushes, and each veneer was fully light cured facially and lingually for 40 seconds. The extended working time of the light-cure-only cement allowed the clinician to seat and clean all four veneers without concern for premature polymerization. A final inspection of the veneers was performed, which confirmed clean margins, patent interproximal contacts, and balanced occlusion—all of which contributed to the creation of a highly esthetic final result (Figure 7).

Conclusion

The placement of minimally invasive porcelain veneers can enable the correction of a variety of esthetic issues in the anterior region. The technique presented in this case allows clinicians to fine-tune esthetic outcomes while maintaining procedural control. In demanding esthetic cases such as this, where precision and predictability are critical, the choice of an appropriate cement with stable optical properties is essential to support high-quality, long-lasting outcomes. 

Gary Radz, DDS
Private Practice
Denver, Colorado

Figures and Images

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Gary Radz, DDS

Fig. 1

Preoperative close-up maxillary view of a 32-year-old male patient exhibiting diastemas between teeth Nos. 7 through 10 and discoloration of tooth No. 8, which had previously undergone endodontic treatment.

Fig. 2

Close-up maxillary view of the final tooth preparations, which were digitally scanned so that the laboratory could fabricate lithium disilicate veneers based on the wax-up design.

Fig. 3

Close-up view of the veneers being tried in with a try-in paste that replicated the shade of the veneer cement to assess the final esthetic outcome prior to cementation.

Fig. 4

Following decontamination with air/water spray and a cleaning agent, silane was applied to the intaglio surfaces of the veneers prior to bonding.

Fig. 5

Retracted view of the tooth preparations being etched with phosphoric acid to prepare the enamel surfaces for bonding.

Fig. 6

View of the final veneers, which were loaded with translucent veneer cement and seated simultaneously, immediately following an initial tack cure but prior to cleanup.

Fig. 7

Immediate postoperative view of the veneers on teeth Nos. 7 through 10 showing the final esthetic outcome with clean margins, proper interproximal contacts, and natural shade integration.

Gary Radz, DDS