“Look at a day when you are supremely satisfied at the end. It’s not a day when you lounge around doing nothing; it’s when you had everything to do, and you’ve done it.”
—Margaret Thatcher
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Is there a better way to accomplish anything? The answer is probably YES! I have had the privilege of practicing dentistry for 47 years and during those years have seen so many remarkable changes in our profession. These continuous advancements, made to improve the treatment of our patients, are what keep me very excited about going to work each Monday. I think this is the absolute best of all times to be a dentist. Gosh, I wish I were able to practice at least another 25 years, but at age 72, I know my time left to be a good dentist is limited. However, I still try to improve on everything I do and that is the reason I am writing this article for Becden’s newsletter. I have been introduced to a better way to prepare lower anterior porcelain veneers and I want to share my thoughts with you.
Like many of you, I have been a continuous student of our profession all my career and I have never heard or read where any of our major clinicians suggested the following technique, but I can tell you, it certainly is beneficial for both you and the lab technician you are using. In fact, when I first saw it prepared on a stone model, I had reservations about it, but I had the courage to try it. Now I believe it to be an improvement over the technique used on many lower veneers I have done in the past.
What is the major change I have made in my veneer preparations? I now create a beveled shoulder from mesial to distal on the lingual surface, about 2 to 3 mm below my incisal reduction. Why is this better??? Good question and the answer is……it will give you and your lab technician a much more solid foundation to work with. Imagine the firm seat that you will have when placing the veneers as well as how much easier it will be for your lab technician to fabricate them.
Dennis, from my favorite lab, Becden, was thoughtful enough to send me a stone model showing the results of this preparation technique. I tried following this design two months ago and will never go back to my old technique. I have to say “thank you Dennis for helping to make me a better dentist.”
Let’s review the technique from beginning to end. I prefer to start my veneer preps with a rounded-end cylinder diamond bur.
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Beveled |
Rounded |
I lay the diamond on the labial surface and start the reduction of the labial surface from mesial to distal. Although great for labial reduction, there is a big problem with round-ended diamond burs for margins that we all need to be aware of. They will create a “J” shape on the prepped margin. For that reason I have changed to using beveled cylinder diamond burs for all my margins. I want a margin that has beveled shoulders like the diagram shown here.
After labial reduction, I now change to a beveled cylinder bur for the gingival margin and for the mesial and distal margins. What I am suggesting is that a ¾ crown preparation will always be better for lower anteriors. I resisted this suggestion at first when I saw it on the model Dennis sent me, but now I believe it is better.
After you make the mesial and distal slice it is now time for the incisal reduction of about 2 mm. Then take the beveled diamond and connect the mesial and distal to create a lingual beveled shoulder. You have now created a preparation that you and your laboratory technician can easily and accurately work with. You will then receive a veneer that is easy to place and is also very strong. Try it; you will like it!
As a result of this learning experience I decided to now use a beveled shoulder finish for all veneers and crown margins. I would suggest you consider this technique as well. You really can “teach an old dog new tricks”. Thanks Dennis!
Becden’s note about the author: Dr. Johnny Savage practices in Ebro, Florida on 83 acres of land and overlooking the Choctawhatchee River in a doublewide trailer. For more than 150 years some member of his family has been practicing there. He has patients travel from around the country to be treated by him, yet is known even more for the numerous patients he has generously treated at no charge, just to help. Pat Brookins, his one and only employee of 15 years says, “Doc is a wonderful, wonderful man, and I am blessed to know him. He does so much for so many people and for humanity in general.” Not only is Dr. Savage highly skilled in technical dentistry, he is passionate about people and happiness. He says, “I’ll be working on happiness forever, it fascinates me. Most nights I’ll put on a cup of tea, listen to some classical music, and just ponder life. I’m thankful God has given me such an active and passionate mind.” As a philosopher and poet he writes memos and lists with title such as the “Ten Characteristics of Enlightened, Philosophical, and Sophisticated People” and “Ten Days to Happiness”. Dr. Savage can be reached at 850-535-2257.
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| Dr. Johnny Savage and Assistant Pat |
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Pictured: Dr. Johnny Savage's uncle and grandfather. There has been a member of his family practicing for more that 150 years — Four Generations of Dentistry. |
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131 E. 13065 S.
Draper, UT 84020 |
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888-344-9991 toll-free
801-576-9991 phone |
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The editor of this newsletter is Emily Webb of Becden Dental Laboratory, Inc. Please send any questions or comments about this newsletter, or suggestions for articles to: emilyw@becdendental.com
©2006 BECDEN Dental Laboratory, Inc. |
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Improved Veneer Preparation Technique
