INDIRECT CERAMIC VENEERS
The previous veneers were removed by using
a fine-grit tapered diamond bur in a high-speed
handpiece, using copious water spray to keep
from heating the porcelain. Care was taken to
keep from removing any more tooth structure
than was necessary to remove the veneers. A
chamfer-ended diamond bur was used to define chamfer margins at the crest of the tissue.
An incisal preparation allowing for at least a
millimeter of overlap was accomplished with
the same tapered bur. Proximal margins were
ended at the lingual line angles to allow for
wrapping of porcelain into the interproximal
areas. The right central incisor was prepared
with a 360-degree design to allow for better
alignment. The left lateral incisor was also
prepared for a 360-degree laminate. Figure 6
shows the right lateral view after preparation
and in Figure 7 the left lateral view can be seen.
considerations: When a patient is unhappy
with another dentist’s work
IN THE CASE DESCRIBED, the patient was dissatisfied with the results of her existing
restorations and was seeking alternative treatment to be happy with her smile once again.
How do you approach a patient who is searching for a better result than what was achieved
with a previous dentist?
Instilling confidence in this patient begins the moment she calls the office. The telephone
introduction should welcome the patient to the practice, instead of barraging her with
questions. Asking about insurance coverage and launching into the rules and regulations of
scheduling does not set the office apart as hospitable, nor does it make the patient feel as
though she has called an exceptional practice.
Listen to the patient first; explain your office protocols second. What is most important
during the phone call is what the patient wants to tell you, not what you tell her. Match her
specific concerns or treatment interests with how your office meets those needs. Spend as
much time as the patient needs to feel as though she has been heard and understood. This
is not a timed event. Appeal to the human side of doing business with the patient, and your
office standards will be more inviting.
The treatment consultation is a critical element to patient satisfaction and practice success. It is not an appointment that can be abbreviated or “sandwiched in” between other
procedures. Whether a treatment coordinator or the doctor initiates this visit, proper time
must be allocated to be sure the patient is comfortable and confident she has chosen the
right office for her care.
Avoid denigrating the previous dentist and treatment. This does not elevate the status of
your practice and creates a negative atmosphere for the patient. Explain your recommendations and focus on the expected results of your care. Tearing someone down does not build
you up. Be the “bearer of good news” and show the patient her future potential. It’s a more
Many people are visual learners. Present before-and-after images of actual cases done in
your practice and show cases that are similar to the patient’s treatment. Help her visualize
how she will feel with a new dental appearance. Spend the time with the patient to give her
the confidence she needs to choose the care you both want.
Figure 4: Overcontouring of proximal areas
Figure 5: Overlapping of proximal surfaces
in the previous restoration
Figure 6: The right lateral view after
Figure 7: The left lateral view
Figures 8a and 8b: Incisal views of the
The incisal views of the prepared teeth can be
seen in Figures 8a and 8b.
By allowing room for proper alignment and
precise margins, porcelain veneers that mimicked a more natural appearance could be
made. Ceramic veneers were fabricated for all
six teeth and were bonded to place using a
resin luting agent.
Continued on p. 93