The bonding of Boca Raton veneers to teeth is a technique sensitive procedure that if not strictly adhered to will lead to failures. To have an understanding of this procedure one must understand the structure of a tooth.
For simplicity sake, a tooth is composed of an outer mineral matrix called enamel and an inner layer called dentin. Dentin is a bone-like material that is composed of tiny tubules that radiate out from within the tooth.
When bonding a veneer to a tooth it is important to recognize which type of tooth structure you are trying bond.
Bonding to Enamel
When bonding to enamel, an etchant of 38% phosphoric acid is usually applied for about 20 seconds. The etchant demineralizes the superficial surface of the enamel by removing calcium.
The removal of calcium creates a microscopic roughening of the surface which in essence increases the surface area of the enamel. The etchant is thoroughly rinsed and dried until the enamel has a frosted appearance.
At this point the adhesive agent is applied to the enamel and air thinned. It is important not to have any moisture in the air applied to the tooth. Once the adhesive agent is thinned, a special curing light is used to illuminate and cure the adhesive.
Now the tooth is ready for cementation of the veneer with a light cured resin based cement.
Bonding to Dentin
Bonding to dentin is more sensitive than enamel. Because dentin is composed of tiny tubules, the principal of etching dentin is to demineralize the dentin without collapsing the dentinal tubules. Once the dentin is etched for 20 seconds, the dentin is dried but NOT desiccated.
This is important because over drying the dentin will cause collapse of the tubules. While there is a light sheen on the dentin a special bonding agent is applied. The bonding agent is allowed to sit on the tooth for at least 20 seconds and then a light air stream is blown over the tooth for another 10-20 seconds to evaporate a moisture wicking agent.
This bonding agent is different because it contains a moisture wicking agent such as acetone which draws the moisture of the dentin tubules while at the same time allowing the adhesive agent to penetrate the tubules. The next step is to cure the bonding agent as you would the enamel.
Preparing the Porcelain Veneer
The porcelain veneer usually is returned from the dental lab with the internal surface already prepared for bonding by being etched with hydrofluoric acid. It too has a frosting white texture.
However, to ensure the you get a tenacious bond, the etched porcelain is treated with a silinating agent that acidifies its surface. The silinated surface is air dried and the adhesive is applied to it as well.
Once this is done, the resin cement is placed on the bonding surface of the veneer which is in turn carefully placed on the tooth. The resin cement is then light cured. Excess resin cement is removed, the bite is checked and your done.
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