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Mini-prep case photo essay_DEC.2008


									     From the Lab | Michael DiTolla, DDS, FAGD

                           Mini-prep case photo essay
      For more on this topic, go to                                                                                       Fig. 5
      and search using the following key words: no-prep veneer,
      minimal-prep veneer, composite veneers, Dr. Michael DiTolla.

     I have come around to no-prep veneers. As techni-
     cians and ceramics have improved, I have received much
     better results on a variety of cases; however, there are still                       Fig. 5: I mark the areas through the matrix and reduce only in these areas.
     cases in which some minimal preparation makes a big dif-
     ference in final esthetics. The following is such a case.                                                                                    Fig. 6
                  Fig. 1

     Fig. 1: A 32-year-old female patient wanted to improve her smile but did not have
     much luck with vital bleaching. Previously, a dentist had placed some direct com-
     posite veneers on the upper anterior teeth, but most had broken off or worn away.
                                                                                          Fig. 6: Minimal reduction
                  Fig. 2
                                                                                                                                                  Fig. 7

     Fig. 2: Once you see this occlusal photo, you can determine whether this will be a                                                           Fig. 8
     no-prep or minimal-prep veneer case. I suggest that you take this type of photo or
     pour up a study model.

                  Fig. 3

     Fig. 3: Based on Fig. 2, we decided that minimal reduction was needed on teeth
     Nos. 7, 9 and 11. A minimal-prep veneer is one that requires enamel removal for      Figs.7-8: Here are the veneers on the day of cementation. Like many
     optimum esthetics but exposes no dentin.                                             patients who had stopped smiling because they didn’t feel comfortable
                                                                                          with their smiles, this patient will have to learn to smile again. This is
                  Fig. 4                                                                  not just an expression. Some patients need to practice smiling in front
                                                                                          of a mirror if they have been hiding their smiles with their hands or

                                                                                          Dr. Michael DiTolla is the Director of Clinical Research and Educa-
                                                                                          tion at Glidewell Laboratories in Newport Beach, Calif. He lectures
                                                                                          nationwide on both restorative and cosmetic dentistry. Dr. DiTolla
                                                                                          has several free clinical programs available online or on DVD at
     Fig. 4: I had the laboratory make a putty wash reduction guide to ensure that I For more information on this article or his
     would reduce the teeth only as much as needed.                                       seminars, visit

xx   December 2008 |

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