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MCG School of Dentistry Quality Assurance Manual

Bonding and Veneering

General Guidelines
Bonding and veneering are useful methods to satisfy patient’s esthetic requirements. They assist the dentist in producing and enhancing an esthetically harmonious and cosmetically appropriate smile. Veneers are state of the art; superior esthetics can be achieved and their permanence is superior to chairside bonding. Bonding is most appropriate for smaller esthetic changes, such as diastema closure.

Certain aspects of treatment planning demand special consideration:

  • Diagnostic models, photographs and imaging techniques are useful as preoperative records and as a means of planning the definite restoration;

  • Periodontal health should be established and any periodontal treatment completed before placement of veneers or bonded procedures.

  • A high caries level is a contraindication due to the increased possibility of recurrent decay;

  • Occlusal contraindications may include bruxism, clenching, wear facets, fractured teeth, tooth mobility and craniomandibular dysfunction;

  • Bonding and veneers are esthetic enhancements and can be replacements for orthodontic therapy. Malocclusions remain as such, but can be given a more esthetic appearance. The patient must be informed when orthodontics is indicated;

  • The patient must be made aware of the potential longevity of the chosen restoration and the cosmetic results they should expect. They do not have the usual longevity of crowns and may require repair or replacement in the future.

Bonding and Veneer - Quality Evaluation Criteria

ITEM

RATING AND EXPLANATION

 

ACCEPTABLE

NOT ACCEPTABLE

Operational explanation

The restoration is of acceptable quality and is expected to enhance patient esthetics.

The restoration is not of acceptable quality.  Damage to the tooth and/or surrounding tissue has occurred or is likely to occur.

Indications

Bonding or veneers are the restoration of choice for requested cosmetic enhancement.  Treatment creates no or minimal harm to teeth or adjacent tissues.

Restoration was made without consideration of other treatment possibilities. Special considerations requiring evaluation are not discovered or taken into consideration. Restoration may cause damage or adversely affect the prognosis of the treated tooth or teeth.

Surface and color

The surface of the restoration is smooth. No irritation of adjacent tissue is occurring. There is harmony in color, shade, and translucency between restorations and adjacent teeth.

Surface is irregular or fractured. Color discrepancy is outside the range of color, shade, or translucency of adjacent teeth.

Anatomic form

Restoration contours are confluent with adjacent teeth and soft tissues, and its exhibits acceptable anatomic form.

Restoration is grossly over contoured or under contoured. Contours are contributing to traumatic occlusion, caries, or periodontal disease.

Marginal integrity

There is minimal evidence of marginal discrepancy into which an explorer will penetrate. Margins are not thick or bulky.

Marginal discrepancy is evident. Marginal overhangs are present or contacts are faulty. Discoloration is found between restoration and tooth structure, excess cement is present, and restoration is mobile or fractured. Caries is detected.

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Patient Services
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December 19, 2005