Acute periodontal gum abscess that caused gum pain. 1) This patient presented with a draining fistula in the gums between teeth #’s 7 & 8. Teeth #’s 8 & 9 had acrylic veneers – not porcelain – made and placed at another dental office about two years ago. Her general dentist had performed a gingivectomy minor gum surgery last year to attempt to treat the occasional swollen gums in this same area. 2) The radiograph of tooth #9 shows a healed apicoectomy from 12 years ago that is not related to the current problem. 3) A gutta percha point was placed in the fistula and radiographed to see where it went. It stayed at the coronal gingiva around the margin of the veneer. The patient was put on tetracycline antibiotics for a week. [This is not a recommendation for everybody!] 4) Reevaluation two days later by the Periodontist showed improvement in gum pain symptoms and gingival inflammation. The acrylic veneer gum margins will be recontoured – reshaped – following resolution of the acute condition.

Acute periodontal gum abscess that caused gum pain. Close-up pictures of the gums. This patient presented with a fistula – gum boil – between teeth #’s 7 & 8. Teeth #’s 8 & 9 had acrylic veneers placed elsewhere about two years ago. Her general dentist had performed a gingivectomy last year to attempt to treat the occasional swelling of the gum in this same area. A gutta percha point was placed in the fistula and radiographed to see where it lead. It stayed at the coronal gingiva the margin of the veneer. The patient was put on tetracycline antibiotics for a week. Reevaluation two days later by the Periodontist showed improvement in gum pain symptoms and gingival inflammation. The acrylic veneer gum margins will be recontoured – reshaped – following resolution of the acute condition.

Lumineers were not used in this case but it is a good place for discussion. Lumineers are heavily advertised as being good because there is little or no teeth drilling involved. The lack of teeth preparation – drilling – may result in bulky thick porcelain teeth. The porcelain is also made differently. Lumineers may be easier for a dentist but we do not offer Lumineers for the reasons stated above.

Repair of a broken tooth veneer. The patient preferred to repair this porcelain veneer. This was rebonded in a manner similar to that of the initial dental veneer laminate placement. The patient was willing to accept the slight compromise in aesthetics and prognosis.

Porcelain tooth veneer failure on an upper left canine. Notice the edge-to-edge occlusion bite in this area and that the original dental veneer did not wrap around to the palatal surface of the tooth.

Some teeth veneer cases involve an attempt to improve the occlusion bite like seen in these pictures. This can create unfavorable vectors of force that will create sheer stresses on the porcelain veneer cement. In these cases the teeth preparation – drilling – should be more aggressive to create some mechanical retention to aid the bond strength of the dental cement.