Dr. Amanda Seay: What Cement Works Best for Ultra-Thin Veneers?
One of the top questions colleagues ask me is:
“What cement do you use for your veneer cases?”
When it comes to choosing a veneer cement system, I look for a system that is as simple as possible to use. Since most of the veneer cases I do are minimally invasive, the veneers are contact lens thin. When seating ultra-thin veneers, viscosity of the cement is critical. I don’t want a cement that is too runny nor do I want a cement that is too thick. If the cement is too runny, and during seating I don’t apply constant pressure, the cement has a tendency to suck back into any pressure void and create a bubble under the veneer. If the cement is too thick, the amount of pressure I need to apply during seating may crack the veneer.
In my experience, the perfect viscosity is one that is runny enough that it evenly coats the veneer and one to which I can apply pressure without much resistance.
Cement shade is another critical element in achieving a life-like outcome in my veneer cases. For 99% of my cases I use the translucent or neutral shade but always want something in my toolbox that I can use to warm up or cool down the translucent shade to get a perfect shade match. Most veneer cements come with a shading system that is based on the traditional A, B and Bleach tooth shades, which can alter the final shade or reflective properties of the final veneer. I am not looking for a complete color change in my final veneers because I depend on my laboratory technician to deliver a veneer that is a perfect shade match to surrounding dentition. What I want most is a system that either warms up or cools down the translucent shade to get a perfect shade match.
When Ivoclar Vivadent recently introduced Variolink Esthetic High Viscosity to their Variolink Esthetic line of cements, I found a cement system that exhibits all these same advantages and more. The viscosity of Variolink Esthetic handles really well for me, and the big difference is in the coloring system. Instead of offering a series of ambiguous tooth shades, the Variolink Esthetic HV offers a 5-color system based on how much do you want to lighten up or cool down the final veneer shade.
For most of my cases, I use Variolink Esthetic Neutral, which equates to a translucent shade, and then I can choose Light, Light Plus, Warm or Warm Plus shades to warm up or cool down the final shade. Frankly, I only keep the Light Plus and Warm Plus in inventory because I don’t use the others often enough. But what if I have a final veneer that I want to lighten up and find that the Light Plus try-in paste increases the lightness too much? Since I don’t have the Light shade in inventory, I simply mix the Light Plus with the Neutral try-in paste to achieve the Light shade. The same holds true with Warm Plus shade. I can mix Warm Plus with the Neutral shade to achieve the Warm shade.
It is a simple and effective veneer cement system that meets all my needs for veneer cases.
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Dr. Amanda Seay, AAACD received her dental degree from the elite New York University College of Dentistry, a global leader at the forefront of cosmetic and restorative aesthetics. She is a clinical instructor at the Kois Center, and has also published articles covering the art and techniques of aesthetic dentistry and dental materials. Dr. Seay is Accredited with the American Academy of Cosmetic Dentistry, the world's most recognized advanced cosmetic dentistry program. This means she's dedicated hundreds of hours to learning the most advanced techniques to provide you with the smile you've always wanted.
She combines her artistic talent, her passion for medicine, and excellence in clinical dentistry to create her own dental practice, focused on cosmetic and restorative dentistry. That’s dentistry redefined!
When not in the office, Dr. Seay enjoys spending time with her husband and their four children. Her hobbies include cooking, traveling, exercising, photography, health and fitness, and beauty.