Veneer Prep Design Guide: When to Open Interproximal Contacts
It is our goal as clinicians to maintain as much enamel as possible when preparing teeth for veneers. However, there are cases when it is necessary to break thru the proximal contacts to achieve optimal esthetics. This guide reviews 7 clinical and esthetic reasons why you may need to open the proximal contacts during your veneer prep design.
What's inside
Closing Diastemas
If the veneer preparation margin extends to the lingual, more ideal contours of the veneer can be realized, providing for improved esthetics, and cleanliness of the veneer.
Rotated Teeth
More aggressive interproximal reduction might be necessary to allow the ceramist to create ‘straight’ appearing teeth in the cosmetic reconstruction of rotated teeth.
Canted or Angled Midline
Opening the contacts on canted or angled midlines may be necessary to create appropriate tooth proportions and symmetry between the teeth.
Dark Teeth
Visible exposed margins can easily turn a successful case into a complete failure if the patient is able to see any dark tooth structure beyond the veneer finish line.
Heavy Stains
Patients that have excessive extrinsic staining on their natural teeth are likely to get staining on their restorative margin.
Reduced Enamel
In conservative preparation design cases, there is the option to do a facial “wrap” of the tooth to provide more retentive form to the veneer.
Laboratory Dictates
Positive collaboration between the dentist and the laboratory technician is critical for ultimate esthetics, and function.
Frequently Asked Questions
What is an interproximal contact?
The interproximal contact is the zone in which two adjacent teeth touch, or meet together. When prepping teeth for porcelain veneers, it is important for the dentist to determine if it is best to maintain the interproximal contact if it is present prior to preparation, or if it is necessary to restoratively replace the contact.
What is a minimal veneer prep design?
Minimal Prep or No-Prep Porcelain veneers are porcelain veneers that require very little to no tooth structure removal before the permanent veneers are bonded to the teeth. Porcelain veneers have the highest long-term success rate when they are bonded to the enamel of the tooth structure. A minimal prep veneer maximizes the patient's enamel to maintain as much tooth structure as possible while also maximizing the success of the veneer. Minimal veneer prep design is not always possible as tooth position and tooth color may require more aggressive tooth preparations in order to create esthetic and ideally contoured porcelain veneers.
How do you treat open contacts?
If there are open contacts, or spaces between teeth (referred to as diastemas), then it may be necessary to close the open contacts to improve the esthetics and to avoid food entrapment. When prepping teeth for porcelain veneers that have open interproximal contacts prior to treatment, then it is critical that the restorative margin be placed to the lingual (or palatal) and placed subgingivally. This subgingival placement of the prep margin allows for appropriate emergence contour and proper interproximal contacts of the porcelain veneer when designed by the dental technician. In order to ensure that there is complete papilla fill, and avoid a 'black triangle' following porcelain veneer placement, the porcelain laminate should be designed to create the proximal contact 4.5 - 5.0 mm from the interproximal bone crest.
What causes an open margin?
Open margins result when the restorative material, such as a porcelain veneer, does not fit to the preparation margin. An open margin can result from poor impression technique, laboratory failure in restoration fabrication, or improper cementation technique. Regardless of the reason for the open margin, the tooth is at a higher risk for decay as bacteria can accumulate in the gap between the preparation margin and the restorative material. Periodontal inflammation may also result from the poor marginal seal and the open margin.
Do you always break contacts for veneer preps?
The decision to break proximal contacts during veneer preparation is dependent on multiple factors, including but not limited to midline position and angulation, the propensity for the patient to develop stains and the need to 'hide' the restorative margins in an esthetically 'safe' zone, rotated teeth that need cosmetic realignment, and dark teeth that need all restorative margins hidden. There are also times that the dentist should open the proximal contacts to aid the dental ceramist in creation of esthetic and ideally contoured porcelain veneers.
Gain veneer prep design confidence with our guide on when to open the contacts.
