Porcelain laminate veneers are a wonderful way to conservatively change the shape and color of teeth with a durable long-lasting restoration. The laminates are extremely thin (thinner than finger nails) veneers of porcelain. They are held in place by a bonding resin cement. The word “bonding” is somewhat of a misnomer as there is very little true adhesion involved. The enamel surfaces of the teeth and the inside surface of the porcelain are etched with an acid solution. This creates microscopic crevasses in those surfaces. A liquid plastic is flowed over these areas and filters down into the tiny crevasses. The plastic is then hardened with the rest of the cement with an intense light source. A silanating agent that has double bonds for porcelain and the resin cement will provide some mild adhesion for that interface and the new generation dentin bonding agents will also help adhere to areas where the dentin , the inner layer of the tooth, shows through. The resin cement can also help with the color of the tooth. The cement is naturally translucent, however, different agents can be added that can change the color and the opacity of the laminate, thus masking any problems with the underlying teeth.
Porcelain laminate veneers are a fantastic way to create an utterly dazzling smile. Since a small amount of tooth structure generally must be removed, it is not a reverisable procedure. If the teeth themselves look good, and the cosmetic concern is the alignment, then there are other alternatives available to get a great smile. Invisible braces (for example, Invisalign®) are now available for many types of alignment problems. This way, the teeth can be straightened in such a way that there will be no changes in the front of the tooth surface. Therefore, it is a reversible procedure. Many a beautiful smile has been created by simple straightening and bleaching.
The pros of the invisible braces approach are cost and reversibility. Fees tend to be about 60% less than porcelain laminates. The cons of invisible braces are retention and inability to mask stains. Once invisible braces have been completed, the teeth must be retained in their position by wearing a retainer each and every night. It’s not as daunting a task as it sounds, but it still requires one to put the retainer in every night. If the teeth are stained in such a way that they cannot be adequately improved by bleaching alone, then porcelain laminates are usually the better alternative.