bonded ceramics

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Hmm, cosmetic dentistry question coming up... can someone tell us the benefits of bonded ceramics vs. ordinary ceramic crowns? Also, and this is the MAIN question, exactly how difficult would the procedure to remove bonded ceramics be (believe it involves drilling them off)? The person looking for the answer needs to have many bonded ceramic crowns redone and is very worried about how difficult this procedure may turn out, and what sort of damage might be done in the process. If nobody knows, fair enough... Here's one definition of bonded ceramic crowns I found:

"The dentine-bonded ceramic crown is a full coverage restoration luted to the underlying tooth tissue via a dentine bond and resin composite luting system. The main advantage of using this technique is that removal of tooth tissue can be kept to a minimum."

From what I can gather, the main difference between all-porcelain crown systems is bonded vs. cemented. Cemented seems to be far more common and easy to replace. So what about bonded?
 
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Bonded ceramics are much harder to remove. Aesthetically they're a bit better. They're generally a little kinder to the gums than cemented crowns and the edge ("margin") can be left above the gum line and be hard to spot. Removing them usually means cutting them off with the highspeed drill, it's not easy.
Bonded crowns use different kinds of porcelain than conventional porcelain jacket crowns.
I wouldn't agree that you need to remove less tooth structure when preparing bonded porcelain crowns, it's about the same.
 
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Hi:
Almost 3 months ago I allowed myself to get veneers & 3/4 porcelain crowns for cosmetic reasons only.
I wasn't told up front about the horrible reduction of my teeth (14 on top). I stupidly assumed that a little preparation would be done and I would be fitted with a veneer the size of a contact lens on the front of my teeth. Because my dentist was trained at LVI, he used the wraparound veneers. Luckily, he did a nice job, but my teeth really look fake. Nice, but fake. Also, some sensivity on one back molar, and a little problem with a premolar. I think both might now need a root canal in the future, but I'm not ready to go back there yet.
Aside from the pain (I lived on Advil - 2 every 6 hours for a month) the biggest problem was my speech. I was totally unprepared and horrified to realize, that the dentist couldn't help me. He assured me for 2 weeks while I was in the temporaries that the permanents would be much thinner and my speech problem would be resolved, but it wasn't. I now am self conscious; with my natural teeth I was confident and full of life. I'm not so much now. I'm very guarded and quieter. I practice certain sounds and am hopeful that my speech will improve. I must say it has, but it's been very difficult. Saying "255 South State Street" is hard, as is "55" "Griffiths" and like sounds.
Fluency and spontaneity in conversation, which I used to take for granted, is now something I would like to have back desperatley, but I know removing the veneers and redoing them might be impossible.
I think these dentists, trained to ACHIEVE EXTREME SUCCESS at LVI do so by compromising their ethics for the almighty $ and should be regulated more closely.
Thank you
 
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Debby,

I can empathize with your problems with placement of veneers.

However, there's quite a lot that can be done in mouth on seated veneers to help improve aesthetics (more natural with embrasures, etc.) and speech problems, which may be due to the length of anteriors - especially centrals.

My understanding is it's quite common to make these adjustments through many dentist's opinions (I've personally had this done) without jeopardizing the integrity of the porcelain.

For me it was night and day. Sooo much happier!

You might consider talking to your dentist about it ?
 
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Debby, would you consider going back to that dentist and let him sort out the things you're unhappy with (trimming anterior veneers to improve speech, making them look more natural, and look into the sensitivity issue, which could be something simple - no need to assume worst-case scenarios)? You must have paid the guy a lot of money, and you should insist on getting the best possible result.
Or is it a case of having lost all trust in him? If so, you might want to consider going back there with a friend-cum-witness to see what he can suggest to rectify the situation. If you don't like his suggestions, you haven't lost anything. Maybe you've asked him already, and he said he couldn't do anything for you - it's not entirely clear from your post whether that's the case.
 
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Regarding sensitivity, Gordon was mentioning to me that it might be due to sth simple - like needing a few minutes more zapping with the light-cure wand. Sometimes the composite cement that holds on the veneers isn't fully set, which allows the material to compress slightly on chewing and the compression moves the fluid in the dentine tubules which causes pain... and zapping a bit longer with the light cure may sort it out. He was talking about veneers though, and I don't know what work you had done on the premolar/back molar. :confused:
 
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reply to Hope

Thank you so much for your reply. First of all Hope, I had no idea that quite alot can be done in mouth on seated veneers to help imporve aesthetics. What is embrasures, etc??? What kind of speech problems did you have?
I would love to be able to talk confidently again. My "f" and "th" sounds are sometimes very embarassing.
How long did you wait before making adjustments to length? I have given it 3 months, and I must say it has improved, but is still noticable. At this point, I don't think it CAN improve any further.
My CD made it clear to me that he can take away, but he can't put it back, so the only adjustment he did was very minor and no adjustment in length after 2 weeks in the permanents.
If he shortened the teeth, would he have to do all 6 across the top?
I believe you when you say for you it was night & day. It really affects your quality of life in a major way!
Again thank you
Debby
 
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Re: bonded ceramics to letsconnect

Thank you for your very quick reply to my post and also for letting me vent my frustrations. I found this website through another website that deletes anything negative and truthful about porcelain veneers. Unfortunately, I used that website for alot of my decision making before I got my veneers, without realizing that in some cases cosmetic dentists see $$$$ when you walk through their door and their staff is trained to be enthusiastic, and put on a GREAT PUSH for you to go through with the procedure. Like the other post said, wham, bam, thank you mam. I believe they are trained that way. I think the dentists even copy their website.
I will go back to him when I'm ready. I feel that it is too soon. I want to be sure before I let him make permanent adjustments to my teeth. It's not that I don't trust him, it's that I fear the change might be worse. My biggest problem is my speech, then the fakeness, in that order. Yes, I did pay him ALOT of money and aside from what I think is his unethical practice of shaving perfectly healthy teeth into nubs without presenting any alternative, I believe he knows what he is doing. I am sure he will address the sensitivity and to tell you the truth, I'll deal with that later. I can avoid the pain by not eating extremely hot or cold stuff.
He did not say that he couldn't do anything for me yet, I am purposely waiting to see how much my speech improves before contacting him again. What if he shortens my teeth and my speech doesn't improve, what if he makes adjustments for aesthetics, and I don't like it??
I now know that there is no "RE DOING". I compromised my teeth and I'm going to be very careful before letting him work on my teeth cosmetically again. I'm scared.
Thank you,
Debby
 
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Debby,

Adjustments were made shortly after veneer seating... a few weeks. My speech "S and F sounds" were really tough, plus the appearance of my centrals and laterals were a bit too long. Overall perception; too perfect to look real.. not enough characterization, or that which gives a unique, natural smile appearance.

Staying conservative we did a little at a time. My dentist was extremely careful about this. After the second revision my speech was completely back to normal - I was ecstatic with the difference just a little tweaking to my smile made in the overall appearance. MORE SO, the fact I didn't have to concentrate to talk. I was back in business!.... finally not self-conscience about opening my mouth!

If memory serves, I've had a total of 4 revisions. To reiterate, a little at a time - probably over 2 months. My dentist didn't mind this at all, in fact he welcomed performing the changes even though required extra chair time. It will be a year in February and he's always said, just to let him know if there's any more "tweaking". To date I'm quite pleased -- really relaxed and happy with my smile. So I think we're through :)

Oh, and incisal embrasures are the small spaces at the edge of each adjacent teeth that break them up.... just as found in natural smiles.

I understand the influence of certain input and some of what you must be feeling. If you ever want to talk or I can help, please do let me know.

Hopeful
 
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Debby,

I negected to answer one of your questions. Not all
6 teeth would necessarily need to be adjusted. For example, for speech, it may only require slight adjustment of the centrals. And perhaps only on the back side for thickness vs. length.

Because of what you've been through, you will take it at your own pace and make that call when you're ready. I would just hate to see you suffer though when it in all probablity could turn out to be quite minor
with monumental improvement. It's pretty amazing what they can do.
 
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Thank You Hopeful

I am certainly more optimistic now that I know someone has gotten good results and had the same problems as I do.
My teeth are nice, but fake looking (too perfect, not too white either, thankfully) I know I can go back for minor adjustments, but until seeing your post, I was afraid that the adjustments might look worse, or not help at all.
I plan to contact my CD today.
Thank you so much!!
Debby
 
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