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Medical Forum / General / Dentistry / September 2005

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bonding / crown question

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T#1 - 30 Aug 2005 07:24 GMT
Hello,

I had bonding done to correct gaps between my front 2 teeth and the
surrounding teeth (6 total) approx 7 years ago. Now due to a chip on
one of the bonding as well as a general "breaking down" of the bonding
it needs to be rebonded or replaced. According to my dentist it will be
impossible to repair the chipped area without it looking patched due to
differences in the age of the material, coloring, etc. He has offered
either rebonding of the 6 teeth or 6 porcelain crowns as my
alternatives. I had a few questions and I would appreciate the input of
posters on this forum.

First, how is the debonding procedure done? Is the material simply
removed with a drill or sanding tool? How long do you think this
procedure would take?

Secondly, I was told I was not a candidate for porcelain veneers due to
the fact that some of my teeth were bonded on the back of the tooth
also, or needed to be. I didnt fully understand this when the dentist
said it and I wondered if anyone could clarify it for me.

I would like the seemingly more durable option of crowns, however from
what I gather it is a very involved procedure with a relatively large
amount of tooth structure removal necessary. I would ideally like to
get veneers.. lumineers look like an interesting option. What are your
opinions on those?

Thanks for your time and input!
Joel344 - 30 Aug 2005 09:13 GMT
Hello!

Joel M. Eichen here. This is a common problem. The answer has to do
with many factors, such as your age, your position in life, how much
perfection you need regarding these teeth. So its not a simple answer.

There are several interesting possibilities. Why not post a picture of
the lower half of your face with a big smile so dentists and others,
can comment on what THEY SEE.

As for porcelain veneers, I prefer them to crowns in many
circumstances. Why? With crowns the dentist grinds the teeth fairly
drastically. If you were to look in the mirror after preparation, you
would not be happy at all. Rightly so. Crowns are often the beginning
of further problems. However, that said, when you need them you need
them. But as a cosmetic choice? Maybe not. Not today. This is the age
of adhesion dentistry.

One small example of problems with crowns is where a post for a root
canal tooth places excessive force on a weakened piece of tooth
structure. I have seen those cases progress to implant or worse!

With porcelain veneers, and a wrap-around technique, there is no
contraindication. Still I prefer the bite to contact tooth to tooth on
natural tooth structure where possible.

Joel

Joel M. Eichen DDS

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Joel344

T#1 - 30 Aug 2005 15:40 GMT
Hi Dr Eichen

Thanks very much for your reply. I am only in my mid 20s and thats why
I was reluctant to undergo any procedure where so much of otherwise
healthy teeth are removed. The bonding was done strictly for cosmetic
reasons, as would any subsequent procedure. I was wondering if you
could explain a little about the debonding procedure as well as what
you mean by a wrap around technique. Does this rule out the use of
lumineer veneers?

Thanks again for your time
Joel M. Eichen - 31 Aug 2005 02:31 GMT
Veneers are of two types ... some are non-prepared while others use a
drastic preparation. When a drastic preparation is used some dentists
carry the preparation around to the lingual or tongue side of the
tooth. That is "wrap-around."

If there is cheesy composite bonding (not porcelain vneers) I simply
grind it away with a nice sharp diamond rotary instrument. It takes
five minutes.

Joel

>Hi Dr Eichen
>
[quoted text clipped - 7 lines]
>
>Thanks again for your time
W_B - 31 Aug 2005 16:03 GMT
>Veneers are of two types ... some are non-prepared while others use a
>drastic preparation.

There is also the mini-prep advocated by Ross Nash.

>When a drastic preparation is used some dentists
>carry the preparation around to the lingual or tongue side of the
>tooth. That is "wrap-around."

This is generally the norm now.

>If there is cheesy composite bonding (not porcelain vneers) I simply
>grind it away with a nice sharp diamond rotary instrument. It takes
[quoted text clipped - 13 lines]
>>
>>Thanks again for your time

--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Joel M. Eichen - 01 Sep 2005 10:45 GMT
>>Veneers are of two types ... some are non-prepared while others use a
>>drastic preparation.
[quoted text clipped - 6 lines]
>
>This is generally the norm now.

REPLY

Did you see Gordon Christiansen's comments about this in the last
Dental Economics (?) magazine? He advocates the no-preparation or
little preparation prep, that ends up in enamel and of course bonds
much better than the dentin prep.

The little prep preparation ......

Gotta think about that for a minute.

Joel

>>If there is cheesy composite bonding (not porcelain vneers) I simply
>>grind it away with a nice sharp diamond rotary instrument. It takes
[quoted text clipped - 13 lines]
>>>
>>>Thanks again for your time
W_B - 01 Sep 2005 17:24 GMT
>>>Veneers are of two types ... some are non-prepared while others use a
>>>drastic preparation.
[quoted text clipped - 19 lines]
>
>Joel

I think the 'no prep' porcelain veneer is bogus.

The mini prep is a good thing.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
 
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