Porcelain veneers, sometimes also called dental contact lenses, have become very popular and encouraged by enthusiasts. How do I know if I should get porcelain veneers or resin veneers?.
In recent years, it has become a craze thanks to the introduction of very special materials developed from Lithium Disilicate. This material allows for high resistance, excellent aesthetic results, and versatility in application.
We would like to discuss and alert the general public, as well as the dental profession, about the need for careful planning of cases to avoid sequelae, complications, or premature deterioration of porcelain veneer work.
The Barriers of Biology and Physics
I often remind clients who sometimes seem to think it's easy to replace human tissues: it's very difficult to develop and process certain materials until they are ready to be used as replacements for human tissues. Therefore, it took years of research to arrive at the materials we have today.
People have no idea of the perfection of tooth enamel: the marvel of creation that allows an extremely hard yet flexible tissue to be formed and built by the enamel-forming organ, one of the most delicate tissues in our body, almost like jelly. It's a temporary tissue; when the tooth finally erupts in the mouth, the enamel-forming organ disappears. But enamel is able to withstand the work of chewing, it's translucent, smooth, glass-like, and has a shape that favors the grinding of food. Enamel forms by covering the dentin and is perfectly integrated into the oral environment.
How can we find a substitute material with such characteristics? We may get there someday, but for now, the most modern option we have is porcelain developed from lithium disilicate. In the process that finally gives it the shape it will be applied to the teeth, this material withstands temperatures of 900 degrees to achieve the necessary strength to resist chewing forces.
Efficiency and Biocompatibility
After producing such a material, we need to be able to bond or cement it onto the teeth in such a way that it stays in place for a very, very long time without coming loose. Furthermore, it needs to withstand the effects of chewing for years without irritating the dental pulp (the dental nerve) and without harming the surrounding gum tissue.
When mentioning possible pulp irritation, it is important to highlight that... Facets of Resin They are unlikely to cause such irritation to the dental canal. This technique eliminates the need for tooth surface wear in the vast majority of cases. The dentist will only perform wear in situations where it is necessary to remove stains that are inside or in the formation of the enamel itself, and even then the wear is much less than the preparation for porcelain veneers.
And it is at this point that we finally arrive at the crux of this article. When a dentist plans and executes a porcelain veneer procedure, they cannot only think about the aesthetic result. There is an ecosystem around and inside the tooth that can suffer consequences from what is done to it. The dentist must first assess the patient's oral health, the dental positioning in the jaws, the presence or absence of diastemas, rotated teeth, reduced interdental spaces, bruxism habits, and then determine if porcelain veneers are the appropriate option.
The first element of the ecosystem: the Gum
Whichever option is chosen – resin veneers or porcelain veneers – it's important to highlight that, beyond the aesthetic factor, the adaptation of these veneers to the gingival margin is crucial for good gum health. In other words, the finish line of these pieces at the gum line needs to be smooth, without steps, polished, without sealing defects, and without cement adhesion flaws.
A step due to poor adaptation along the gum line can lead to the accumulation of bacterial plaque, which will trigger gingivitis. The risk of caries and staining under the veneer cannot be ruled out in poorly adapted veneers or those with sealing failures during cementation. Photo number (x) shows intense gingivitis accompanying poorly adapted veneers in a patient without care instructions.
The entire process described in the first article about Aesthetic Veneers may seem simple, but it requires attention, patience, and knowledge of the technique. For example, a bonding session for 10 veneers can take a whole day.
Everything to ensure bonding without contamination from gingival fluid or blood.
Precautions regarding attempts to compensate for dental misalignment.
There are cases where patients have rotated or misaligned teeth. When such problems are mild, the dentist can correct (hide) these imperfections by applying resin or porcelain veneers. But this requires careful consideration. Trying to mask or compensate for certain distortions and deviations from the ideal natural condition can conceal and trigger or worsen periodontal disease.
Anyone familiar with dental and periodontal anatomy knows that a rotated tooth in the dental arch often suffers from excessive proximity between its root and the roots of neighboring teeth. This also means a very thin bony separation layer (interradicular septa) between its root and those of neighboring teeth.
But that's not all; a rotated tooth in the arch also suffers from an exaggerated proximity to its neighbors in the cervical region, the "neck" of the tooth, the point where the tooth submerges into the gum. At this point, the gum suffers strangulation due to the proximity between neighboring teeth. This produces localized gum failure that can lead to bacterial invasion and bone destruction, which characterizes Periodontal Disease.
It is necessary to analyze whether the correct approach would be to first correct these distortions through orthodontic treatment, correctly repositioning the affected teeth within their bony base. If achieving perfect positioning is not possible at this stage, at least these distortions should be minimized. The final result will be much more stable.
The condition of the gums prior to treatment is also an essential factor for the successful cementation of veneers. Inflamed gums will cause bleeding, leading to distortions during impression taking and scanning. At the final stage of treatment, it will prevent a dry and clean environment, compromising the effectiveness of the cementation.. Without to discuss the possibility of the condition worsening after cementation.
The second element of the ecosystem: Dental Pulp
In the first article where we talked about the porcelain veneers We want to make it very clear that in the process of preparing the teeth, a certain amount of tooth enamel needs to be removed to create space for the porcelain veneers. Ideally, the dentist should perform minimal tooth preparation so that the veneers fit properly, but most of the time the preparation is not that small. Because of this, it is necessary to anesthetize the patient during the preparation, during the impression taking, and at the time of cementation. Without anesthesia, the process can be unbearable for the patient.
Because of this wear and tear, some people may experience temporary tooth sensitivity after the veneers have been applied and the case is finalized. If that's all, that's great.
The younger the patient and the greater the wear on the teeth, the higher the chance of developing pulpitis, an irreversible inflammation of the dental pulp that will necessitate root canal treatment, often after the case has been completed.
Even in the final session of bonding the veneers, the dentin surface must be dry to allow the cement to adhere. However, the dentist also cannot overdo the use of compressed air for drying. Excessive drying can cause irritation of the dental pulp (dental nerve).
Porcelain Veneers or Resin Veneers?
A note about patient age: younger patients have a thinner, more permeable dentin layer, and are therefore more sensitive. The area of the dental pulp is larger in younger patients. The older the patient, the thicker the dentin layer and the smaller the area of the dental pulp; this improves pulp tolerance to these aggressions. So if you are very young, don't rush into getting porcelain veneers. You run a higher risk of needing root canal treatment on several teeth.
For very young patients, resin veneers are preferable.
For now, opt for composite resin veneers. They are also a good option for cosmetic dental treatment. They consist of thin layers of composite resin that are applied to cover the visible surface of the teeth. These veneers can correct dental imperfections, stains, discolorations, irregularities, gaps, small fractures, or slightly misaligned teeth.
Resin veneers can be an effective solution for improving the appearance of a smile.
They generally require little or no wear and tear on the tooth enamel.
When deciding between porcelain veneers or resin veneers, remember that adolescent patients will likely experience changes in their smile line – a shift in gum height – so it would be better to opt for the reversibility and versatility that resin veneers offer.
For adult patients, porcelain veneers are preferred.
Now, if you're over 25 or 30 years old, then you're in a position to seek more stable treatments. You can look for a more durable and aesthetically pleasing solution. Porcelain veneers are a good option.
If you store tomato sauce in the refrigerator, some in a plastic container (resins) and some in a glass container (porcelain), after a few days, which container will be stained? Similarly, resins will require more frequent polishing to maintain color stability.
Comparison Chart Between Resin, Porcelain, and Contact Lenses
| Comparison | Resin Veneers | Contact Lenses | Ceramic Veneers |
| Costs | low/medium | high | high |
| Durability | 5 years | 10 to 20 years | 10 to 20 years |
| Color Stability | low | high | high |
| Place of birth | good | excellent | very good/excellent |
| Maintenance | every 6 months | every 2 years | every 2 years |
| Care | *Don't bite objects* | *Don't bite objects* | *Don't bite objects* |
| Reversibility | Yes | It depends on the wear and tear. | impossible |
| Gum Damage* | low | low | low |
| Damage to the Pulp | very low | low | medium-high |
Avoid opening soda cans or performing any action that could also put your teeth at risk.
Therefore, think carefully and analyze the best option. Think with a long-term vision and remember to preserve young structures.
Author: Nivaldo Pinho Gonçalves, Periodontist, CROSC 9696.
Suggested Reading: https://pdfs.semanticscholar.org/cc08/20f8c7eba2ed4c8f465ba9adf196c2f35073.pdf
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