How to Seat Maxillary Veneers - Dental Minute with Dr. Steven T. Cutbirth, DDS
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In this Dental Minute video, Dr. Cutbirth discusses how to seat maxillary veneers.
Dr. Cutbirth is the Founding Director of the Center for Aesthetic Restorative Dentistry (CARD) (www.CenterforARD.com) and maintains a full-time restorative and cosmetic practice (www.WacoSedationDentist.com).
Caroline Hobby is host of Nashville Insider and the syndicated podcast HYPER! with Caroline Hobby. (www.carolinehobby.com)
Edited by Casey Balda.
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Absolutely amazing tips. I have joined your Masterclass membership as well. I'm cementing a big veneer case today and always watch your video in the morning of the case so I can follow your advice to the letter! Thank you for being such a great mentor.
Glad the videos are helpful. Follow the details precisely and your cases will go well.
It is the best lecture and advice for veneer cementation online. I really appreciate it!!😊
Glad the videos are helpful.
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one of the very best video lessons I've ever watch❤️❤️❤️❤️
Fantastic! I hope you are subscribed to DentistryMasterClasses.com for the very best videos.
Thank God I found this video! i have always struggled with cementing multiple teeth with resin cement but this video has given me life saving tips...thank you Dr Cutbirth.
Welcome.
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Great Work! Thanks for sharing of Your experience!
Glad the videos are helpful.
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Great lecture sir. The best part being...you backed the clinical tips with reasons.
Glad you liked the video. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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I wish you were my clinical professor Dr Steven❤
Love from Dubai
Watch the videos in DMC.com. I will also be giving monthly webinars on different topics available to the subscribers of DMC.com. if enough dentists support the teaching channel.
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Thanks a lot for your volunteer advice
You are welcome. Glad the videos are helpful.
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Your videos and techniques are great, thanks. Do the courses you provide have CE credit?
Yes, the videos do have CE credit. Glad the videos are helpful.
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What a great video that is filled with great tips and hints everywhere, a simple advice on the direction of cement placing to avoid bubbles is something not every instructor would tell you! Most of the steps i follow in veneer cementation is very similar to yours, but reaching those conclusions and protocols show alot of experience and practicality that is presented in a simple and clear way. I wish you had posted those videos sooner so i would made less mistakes but late better than never.
Thank you
Thank you. I am glad you like the Dental Minute videos. If you like the DM videos, you will love the DentistryMasterClasses.com videos. DMC.com contains an entire video library of all the DM videos plus all the DMC.com videos. DMC.com are comprehensive cases, including the most complex cases, plus the DM videos. Check it out.
Thanks so much this was extremely helpful!
Terrific. I hope you are subscribed to DentistryMasterClasses.com if you want a lot of the really good teaching videos.
Excellent work!
Thank you.
Really amazing work and video
Thank you. Subscribe to DentistryMasterClasses.com for an organized library of all the DM videos plus many complete comprehensive cases on most dental procedures as well a purely technical discussion videos.
Another great video! Are you using Scotchbond Universal or Single Bond Plus?
Universal.
Thanks D Cutbirth, I cemented 9 veneers today 15--- 24. Followed your exact protocol and it was extremely useful. Only issue I faced was the veneers would sometimes slip off the wax during etching, adhesive treatment, etc. Do you happen to have any tips to address this problem?
that*
The veneers are treated by the laboratory technician prior to sending them to me, so I do not etch/treat them in my office. If you are etching/treating the veneers in your office, do not use the transfer cotton tipped applicators/rope wax until the veneers are treated. The veneers I am now placing are e-max, so they are treated differently that feldspathic porcelain. Watch the video in DMC.com on treating lithium disilicate crowns and veneers. You should place the primer/adhesive on the veneers and blow it off with the transfer cotton tipped applicator/rope wax on the veneer. The rope wax will not come off when the adhesive/primer is blown off.
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Thanks so much for the reply. I did not silane treat the veneers as you mentioned. Many people will often be skeptical. What would your advice be for those that are?
I used G-premio bond as an adhesive. Will that be an issue?
You do not need silane and it can be a contaminant if not used correctly. I am not familiar with the adhesive you mention. I have always used the 3M Rely X system. I think most adhesive methods are good so long as you use them as I am instructing in the videos.
Dr. Cutbirth, once again thank you so much for your videos as they are extremely helpful. Could you share with us what type of unfilled resin you use to temporarily cement your provisional restorations? (I'm sorry if it's discussed in another video. I will be checking out rest of them but wanted to ask before I forget) - Dr. Moon
3M Scotchbond. No primer, just unfilled resin.
Thank you so much DR. for this very important and valuable video, within 2 days I will be cementing my first ever veneer case and I'm happy that I found these beneficial tips, I wish every thing will goes well.
I have a question: I noticed that while you are removing the excess some tissues start to bleed, isn't it going to affect the bond? what shall I do if I face the same or maybe more bleeding surface?
No, the bleeding will not affect the bond because the resin is already partially cured before the excess is removed, so the micro gap between the veneer and the tooth is sealed by the partially cured resin. It is very, very important not to remove any excess resin until you have partially cured it so it "peels" off, and does not "wipe" off. I demonstrate this method in many videos in DMC.com.
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Great tip about the etch!!!
Glad it was helpful.
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Hello Dr, Thanks for suck amazing videos. Is there anyway we can get a list/brand of the materials used?
Yes, the materials are listed in every video. Watch the comprehensive case videos in DMC.com if you really want your practice to take off.
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Beeing a dental surgeon... Ur my idol....
Huge respect from India 🇮🇳
Thank you. How is dentistry in India?
@@centerforard great going sir... And im constantly listening and viewing ur videos.. To upgrade my knowledge.... Thnk u so much sir. HUGE RESPECT FROM INDIA 🇮🇳
Very informative videos.
Do you cure the adhesive on teeth and on the inside of veneers before adding the veneer cement?
No, I do not touch a curing light until primer/adhesive and filled resin are all placed on the veneer and the veneer placed on the teeth. I do not want a thickness of cured adhesive to prevent complete seating of the veneers.
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Thank u dr for the informative video. Isnt rubber dam isolation mandatory during veneer bonding.
No. I am not sure how you would use a rubber dam for veneer placement. Use 2x2 gauze pads to isolate the teeth. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Thanks for sharing this information, greetings from Chile!
You are welcome! I have heard Chile is a beautiful country.
I loved it very much .. I have two questions .. The first is that the uncure bond interacts with the cement? .. The second, has pumice been used with the polishing ? Because the Pumice produces oils that contradict the complete adhesion. It must be free of fluoride and oils. Thank you
Use pumice and water in a prophy cup to clean the prepared teeth after provisional veneer removal, then wipe the prepared teeth with alcohol on a cotton ball. Following etching, blow off the primer/ adhesive from the prepared teeth and the tooth side of the veneers, place the luting composite in the veneer, seat the veneer on the tooth, cure minimally, remove excess luting composite, then cure 60 seconds on facial and palatal surfaces. Do not cure anything until you have seated the veneer. Never wipe off the excess luting composite/cement. It should peeled/broken off.
Dr. Cutbirth, what is the likelihood of fracture of veneers placed on maxillary canines in a patient with canine guidance? Thank you
Very small if you use the methods I am teaching and if they wear a Nightguard. Bruxism is the enemy if no Nightguard.
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Thank you for this informative video
Can you make veneers if the occlusion is edge to edge position in the front teeth?
Those are tough cases because of the potential constant biting pressure on the veneers.The likelihood of veneer fracture is much greater that that of a veneer in a class 1 or 2 occlusion. I would be very careful and hesitant to jump into an end-on veneer case. If you do decide to take one on, be sure you write out the potential downside of the restoration and have the patient sign to agreement. You do not want to guarantee those veneers. There are instances where veneering is the only logical option and, because of the condition or cosmetics of the teeth, something must be done and you do not wish to extract the teeth and place something like all-on-4/6. In those cases, you do not want a revolving door of broken veneers. You do not want the patient's problem to become your problem. Remember, veneers will not wear like natural teeth, either the tooth, the luting resin or the veneer will break. Some wise dentist once told me, "There is no restoration a patient cannot ruin if they try hard enough."
Excellent work
Thank you!
minute 15: that's exactly what happened to me once, I had a big void of cement on a central veneer and I had to redo it to fix it up! which kind of sticks do you use for placing the veneers? I use optrasticks van ivoclar but i don't like them...
The important thing is to be sure the tip of the veneer luting composite syringe remains in the resin as you squirt the resin into the tooth side of the veneer. If the tip should loose contact with the resin being squirted out, into the veneer, a void may be created causing a dark spot on the facial of the veneer.
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.
thank you sir it is very informative video , i have some questions if you do not mind
- why not using try in paste rather than water ( may be it is stronger and more temporary fixed than water especially if we want to check occlusion
- occlusal check some times is dificult in the try in ( specially in cusped and bicusped area cause it moves the non cemented venner ( especially if try in with water ) and even with try in paste
- can we use sickle or curved surgical blade to remove excess luting paste ?
- is the bleeding induced by flossing after initial curing can cause risk to dicoloration or complete curing or staining the luting
- sometimes it is difficult to isolate etching in the enamel from the dentin part of the tooth
thank you a lot
I address try in paste in some of the Dental Minute porcelain veneer videos. It is messy and I do not feel it gives an accurate reading of the final shade of the seated restoration. Please refer to my Dental Minute video on "Matching Difficult Porcelain Veneer Shades." Never check the occlusion of porcelain veneers before the veneer is cemented and cured completely. Yes, you can use a #12 Bard Parker blade or a scaler to remove the excess luting composite. No problem with bleeding after initial curing, but don't over do the flossing in this stage. You are just trying to remove the luting composite in the inter proximal so you can floss. Etching enamel vs. dentin should not be a problem if the etch is a gel.
I would encourage you to subscribe to DentistryMasterClasses.com. It is only $15/month. DMC has an organized library of all videos as well as comprehensive cases which will not appear in Dental Minute videos. You will love DMC!
thanks so much sir for your kind reply
Thank you so much for your videos 👌🏽😄
Glad you like them! Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
Excellent video!!!
Thank you. The comprehensive cases are in DentistryMasterClasses.com. I think you will really enjoy the library and comprehensive cases.
Hello Doctor , I hope you answer my question..
What if the contact is closed after completing the curing of the cement .. how can I easily open it .. ? I always get afraid from bleeding during flossing so I cure once I see bleeding then I struggle with contact opening..
Please help
Don't cure until all the veneers are seated. Watch the videos in DentistryMasterClasses.com on seating veneers. I go over inter proximal cement removal in all of them.
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Thank you dr for the great video, case of completely set luting composite in the interproximal area to a point floss cannot pass , what will be the best way to remove it ?
Use a small tipped, 12 fluted carbide burr with light pressure and water.
Thanks alot dr
Thanks thanks thanks for sharing these tips.
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can we use rely X veneer cement to cement an emax crown? lets say 3 front teeth are prepped for veneers and 1 tooth is for emax crown?
In that case would you use same cement to bond veneers and a crown? or would you use a different cement to cement the crown?
Rely X for the veneers, because it must be cured with a curing light. Unicem C&B cement for the crown. It is self cure.
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I would love to be contacted to be used for a tutorial, my top teeth need so much work since at 46yrs old I still have baby teeth that never fell our. I would gladly volunteer if the outcome was this great.
Sorry, these cases come from my private dental practice in Waco, Texas. I practice dentistry for a living just like other dentists.
Dr. Cutbirth, It's been a while. I should come down to Dallas and redo the veneer course. I just haven't done a lot of them, I lean towards crowns. Veneers are more time consuming on the seating process. I like your reasons for lower veneers over crowns. Just reviewing technique, are you still using the same materials and steps or have you modified anything since this video? You & Caroline has done a great job on these video's.
Subscribe to DentistryMasterClasses.com. It is only $15/month and includes an organized library of all the Dental Minute videos plus comprehensive cases, including veneer cases, as well as important articles. I am giving a course in Dallas in September on Complex Restorative Cases. including full mouth reconstruction and increasing vertical dimension. I am giving another course in November in Dallas on Small Diameter Implant Supported Full and Partial Dentures. Call Bx at my office and come join us. 254-772-5420.
Very informative
Thank you Dr
You are welcome.
I don’t understand what you mean by leaving it wet and doing that for fillings too. Isn’t that a no no for having a wet tooth and then mixing water with primer/bond?
Moist is the better word. The acetone carrier with the primer is hydrophilic, so it is drawn to moisture. The damp surface draws the acetone and primer into the damp surface.
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Nothing more difficult or labor intensive than veneer restorations..
They definitely are a specific procedure if done well.
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thank you prof many many benefits
Glad the videos are helpful.
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hi dr you advise not to cure the bond , my question is what if a clinician dont have a high intensity light? will
it still have a good curing for the cement and bond? thanks
Sorry, I can't answer that. I think you must have a curing light to cure the unfilled and filled resin, but I am not an expert in that area. I have never tried seating a veneer without a curing light. I suppose you could use self cure resin. At one time I used self cure resin, but it has probably been 20 years ago. There is more time pressure on the operator with self cure resin if you are seating multiple veneers at the same time because the resin is curing as you are seating.
Love your videos Dr.Cutbirth. Thank you for providing such an educational resource to help the next generation of dental providers. Only thing is the opening jingle song. Kinda irritating, I think you can come up with a better theme song. But otherwise much respect and gratitude for your contribution to dentistry.
That song is never going away! My daughter is a singer/songwriter and program host in Nashville. She and her friends wrote the jungle for the opening. It is my favorite part of the videos.
Doc......why not to cure the bonding agent?
I do not want a cured adhesive thickness on the tooth before seating the veneer.
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@@centerforard So doc....this logic should hold true even for Cl.V restorations?
Sir thank you so much for this vedio🙏🙏
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Hello sir,,,Does dual cure cement always go through greying phase even if we light cure it!!!
I haven't used duel cure cement for veneer cementation in 20+ years, primarily because of the grey phase it goes through. Use light cured composite for veneer cementation. You can control the shade much more effectively.
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does this curing technique work for removing a crown cement like durelon?
Sorry, I do not understand your question. Are you asking about curing filled resin or cutting off an old crown cemented with durelon? Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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@@centerforard when you cure quickly and flake off the margins
Durelon is not a curable resin cement. With Durelon, just wait until it has initial set and peel it off with a scaler, do not wipe it off before initial set. Take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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Hello. What’s with patients occlusion? Seems 2 dental class, don’t you think patient will brake this long veneers ?
Alex, please refer to my Dental Minute video on "How to Make Veneers as Strong as Teeth." We try to cantilever no more than 2mm of porcelain off the incised edge of the prepared tooth. Up to 4mm can be cantilevered off the incised edge in certain circumstances, but the chance of porcelain fracture increases. Porcelain veneers are as strong as natural teeth if you follow the protocol I am suggesting. Most patients, including all porcelain veneer patients, should wear an appropriate night guard while sleeping to help prevent porcelain fracture and wear of the opposing teeth if they brux/grind the teeth while sleeping.
Ivoclean is even better than using isopropyl to cleanse the intaglio of the veneer. In my experience exposure of gingival tissue with 38 % phosphoric acid most often causes gingival hemorrhage. I almost always place a size 0 retraction cord before bonding veneers. I completely agree that one should not attempt to remove excess cement until the initial set of the resin cement. After the initial set of the resin cement I cover the margins of the restorations with glycerin to prevent oxygen from preventing the complete polymerization of the resin cement at the margin.
You are incorrect regarding 38% phosphoric acid causing gingival hemorrhage. I have successfully used this technique daily for many, many years. It has never caused gingival hemmorage, but causes the bleeding site to "scab" and clot. I cannot imagine what you are doing to have it cause bleeding. I do not leave the phosphoric acid on the bleeding gingiva for more than 1 minute, and usually only 45 seconds. I used to cover the margins with glycerin, but stopped because there is enough mass of excess composite resin at the margins to inhibit oxygen, so I do not feel it is necessary. When the excess filled resin is removed with a scaler or 12 fluted carbide burr, it is set hard as a rock. I try to eliminate steps that are not necessary, such as silane placement on etched veneers, because every extra step affords a possible contamination of the restorative site or restoration. I do not place retraction cord at the veneer seating appointment because the composite luting resin will adhere to the cord and the cord must then be "cut away" with a burr. Also, placing the cord might cause gingival bleeding, and that is a no, no during the seating appointment. Ivoclean is fine, but isopropyl alcohol has been effective for me since I began placing veneers in the early 80s and it is simple and something all dentists have on hand. Over time you too will simplify your procedures and get away from a "special" material vs. using something common that is just as effective. Thanks for your comment. It brought up several points. How long have you been in practice?
@@centerforard I started in 1980 Thanks for sharing your videos.
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Steven I would use a serrated strip to remove excess you can't floss, I find it easier than the fine high speed
Great if you can get the serrated strip through the contact. If you cannot get floss through the contact, you will not be able to get a serrated strip through.
I am a maxillofacial surgeon going into gen practice.. this is just too much knowledge for free..
Thank you. You are probably correct!. I have been in practice 40 years as of 7/6/21 and wish to "give back" some of the knowledge I have learned through the years of practice. Many excellent practitioners influenced and helped me become proficient in many areas of dentistry. If you want the really good videos and cases, take your practice to the Top Tier. Subscribe to DentistryMasterClasses.com for an organized library of all the Dental Minute videos plus many complete comprehensive cases and many very important articles. New cases are added weekly. Only $20/month.
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Are veneers supposed to be ground down flat? Mine look so fake. Flat, discolored and not uniform in size.. The dentist "polished' the surfaces to remove the dark color in 3 veneers. It was not polished it was ground down and they are still gray. What should I do to make them better? I was given none of these preparation instructions. BAD dentist.
Sorry, I cannot comment without examining you.
I totally understand. Thank you! I can only hope to one day soon make an appointment and fly out.
How to clean veneer cement between teeth after become hard?
Just cure the luting composite initially for a fraction of a second on each veneer so it is just "crunchy," not completely cured. The objective with the initial cure prior to excess cement removal is to peel off the excess luting composite, not wipe it off. If you wipe it off, there will be suck back in the micro gap between the veneer and tooth, creating a space for bacteria causing potential sensitivity, stain and decay.
What kind of alcohol mr?
Isopropal, rubbing alcohol. Be sure to place 2x2 cotton squares in the mouth to isolate the teeth.
Like 🙏
Glad the video was helpful.
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Aren’t veneers suppose to give you a nice smile? His smile still looks horrible, no offense to the poor gentleman.
I wonder why you would make that comment? What did you not like about the restored smile?