Full-arch maxillary and mandibular impressions were taken with a polyvinyl siloxane impression material and an occlusal registration was made. Provisionals were made by placing a bisacrylic material into a vacuum-formed acrylic shim made over a stone model, which was created by duplicating a wax-up of the desired end result. The shim was placed over the prepared teeth, and the bisacrylic material was allowed to set before it was teased off of the prepared teeth using a scaler. The margins were trimmed with an acrylic bur and a sandpaper disc. The prepared teeth were spot etched with 37% phosphoric acid gel for 10 seconds, rinsed, and dried with an air/water syringe. A light-cured flowable composite resin was used as a cement. The provisional veneers can be seen in place in Figure 7 after the excess flowable composite was trimmed with a carbide finishing bur and the margins were polished with a polishing cup.

At the lab, the impressions were poured in die stone and four ultrathin veneers were fabricated. Platinum foil matrix material was swedged onto the dies and powdered porcelain was stacked onto the foil before it was fired in a porcelain oven. Only a translucent enamel shade was needed for the effect of new tooth surface. The veneers are shown on the working model in Figure 8.

When the veneers were returned, they were tried in using a drop of water as a try-in medium. After patient approval, they were bonded to place. The prepared teeth were etched for 10 seconds with 37% phosphoric acid, rinsed thoroughly with water from an air/water syringe and left slightly moist for the wet bonding process. A bonding agent was liberally applied with a brush and air dried. It was light cured for 10 seconds with an LED curing light.

The Final Result

A close-up view of the veneers can be seen in place in Figures 9 and 10. In the after image on page 116, you can see the patient’s new smile. By adding only four ultrathin porcelain veneers, her smile was esthetically improved to her satisfaction. Only minimal preparation was required for this case. Experience has shown that the lamination process of the bonding procedure strengthens the thin ceramic so that such a conservative approach can be taken.