I’ve used a few different materials and techniques when cementing porcelain veneers. To be frank, I’ve often found it to be frustrating. Why? Because I don’t use the special veneer cements all that often and there’s a ton of steps. Mix this with that, then mix some more stuff together and say a prayer. No thanks.
Fortunately I’ve found a product that makes cementing veneers easy. Variolink Veneer (Ivoclar) is a total-etch resin cement. We need all the bond we can get when inserting porcelain veneers, so total-etch is the way to go. For a quick review of resin cements, check out this post here.
A patient presented to my office to replace a fractured composite resin veneer on tooth #8.
Beautiful veneer fabricated by Marotta Dental Studio. Notice that the intaglio surface has already been etched buy the lab.
It’s important to ask your lab if and how they will treat the surfaces of your veneers. Marotta already used a porcelain etch, so I won’t need to do that step. If your lab does not etch for you, you’ll need to apply 9.6% hydrofluoric acid for a certain amount of time. There is a lot of variability in the literature about how long this should be, anywhere from 120 seconds to 4 minutes, depending upon your ceramic.
After taking off the temporary, I like to insert the veneer with a try-in paste. I still have a chance to raise or lower the value of the final result with a shaded cement. I’ll also check the occlusion to make sure I’m not only hitting right on the margin of the veneer. This could lead to exfoliation of the restoration and should be avoided. As you can see in the picture below, I needed to adjust the bite a bit to move that occlusal mark.
Try in pastes are available for the perfect shade match. Also evalaute the occlusion; we don't want occlusal marks at the margin!
I recommend placing a rubber dam to ensure adequate isolation. We need every bit of bond we can get, so moisture contamination is our enemy. I’ll also tie some floss around the adjacent teeth to help clean up.
Rubber dam isolation with floss tied around adjacent teeth. This will help remove interproximal cement.
I wash out the veneer and apply phosphoric acid for about 10 seconds. This does not re-etch the veneer, rather it decontaminates it. I then apply silane (Monobond-S) and let air dry. The veneer is now ready to go.
Decontamination of the veneer with etch followed by silane application (Monobond-S).
To prepare the tooth, I clean with pumice (non-fluoride), etch with phosphoric acid and bond (ExciTE). Now the tooth is ready to go.
Pumice debridement of tooth followed by etch and bond.
Squirt in your selected resin cement shade to the veneer and insert. It couldn’t be easier! I like to spot cure for a few seconds and then begin to remove excess cement. It won’t be rock hard yet but is also won’t be runny. I follow up with a longer 30 second cure and polish.
Resin cement applied to veneer and inserted.