By Kevin Brown, DDS, AAACD

One of the most challenging parts of the AACD's Accreditation criteria may very well be the Case Type V: Six or more direct resin veneers. In order to be successful with this case type, proper treatment planning, case preparation, instrumentarium, layering techniques, and polishing will all come in to play. This kind of minimally invasive dentistry is becoming more popular and widely accepted by both dentists and patients, as the results rival those of porcelain restorations, without having to drill the natural tooth structure. The fact that composites cost a bit less is a bonus, but in general, the selling point of composites is that patients can preserve their enamel. 

"I do my own diagnostic wax-ups, and I highly recommend this practice to you."

Effective Treatment Planning Starts Here

Proper treatment planning is key to predictable outcomes. I begin with an hour-long consultation in order to evaluate the bite, take quality photographs, and discuss materials and options with the patient. Risks versus benefits are reviewed with the patient in order to arrive at the best and most minimally invasive treatment for the patient. 

1. Take alginate impressions
2. Prepare models
3. Fabricate bleaching trays
4. Fabricate diagnostic wax-up

I do my own diagnostic wax-ups for several reasons and recommend the practice to you, as so much information can be learned in this process. For example:

• Necessary tissue modification to the gingival zeniths
• If any tooth reduction is needed
• Where addition of composite will look the best when dealing with excess spacing
• Evaluate how much of each tooth will need to be covered with composite
• Decide which composites and colors I will need
• If I can make it look good in wax, I can make it look good in composite!

When creating my own diagnostic wax-up it allows me to form a mental picture of the restoration before my patient even shows up for her appointment. I already know the final outcome, I simply need to execute it!

To continue my step-by-step process of completing direct composite veneers, take my 2-CE course, a live patient, hands-on video, "Direct Composite Veneers."