Stained Veneers: How Do I Prevent This?

posted in Cosmetic Dentistry, Hot Cosmetic Dentistry

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Dr. B. asks:
I have a new patient who is dissatisfied with the veneers she has on her maxillary anterior teeth. I will be re-doing the veneers from canine to canine. The veneers actually were quite well done. The margins are excellent and the gingival tissue is healthy. The teeth are asymptomatic and not sensitive to cold or sweets. The shade is matched very well and they frankly look quite natural. The problem is that on all of these veneers, the gingival margin is stained dark. It actually looks like someone took a dark pencil and drew a dark line across the cervical. How do I prevent this from happening when I remake these veneers? I want to get this right for her. I am a recent graduate and have not had much experience with this.






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8 Responses to “ Stained Veneers: How Do I Prevent This? ”

  • doctorberg November 18th, 2008

    That usually happens when you use hemostatic solutions with iron or when there is bleeding during the procedures(drilling, impresion tacking or fatally while cementing).
    If you avoid bleeding or hemo solutions with iron you can get a better result,remove all the staining and use some peoxide to ensure that, also you will get a better result if you use a good adhesive and cement (I use ultrabond from denmat that has everything you can possibly need).
    in terms of hemo solution I use for this cases the Viscostat clear by ultradent. There are instruments specially designed to protect the gingiva while drilling and the use of retraction cord(i prefer the name separation cord) in two layers (usually a 000 or 00 and a thicker like 1 or 2 on top, I use ultradents non impregnated ultrapak) and leaving the deeper one while taking the impression and doing the temporaries and while cementing too.
    This should help.
    best of luck

  • Dr Olim November 19th, 2008

    If the veneers became stained at or soon after placement the cause was likely contamination at the time of cementation. Latent staining after years in function could occur also from poor cement choice, bruxism and/or hyperfunction, or the gingival finish line on dentin or cementum. Tooth flexure often occurs there causing debonding at that point.Good luck.

  • Dr. Child November 20th, 2008

    Encourage excellent hygiene during provisionalization, well made provisionals, consider chlorhexidine rinses, Hemodent or Viscostat clear for retraction, proper use of rubber dam or similar devices, light cured luting resin or amine free dual cured luting resin. Read as much as you can on materials and esthetic procedures, take hands-on courses, set aside enough time for the procedures, and work with a good ceramist. Good luck.

  • R. Hughes November 20th, 2008

    Bleaching will do the trick.

  • Dr Lam November 21st, 2008

    I think that using cord when doing the impression is counter-productive in most cases - one notable exception is when you are re-doing veneers and someone else has prepped previously very sub-gingivally. The prep should always be,at the very most, within the free gingival sulcus and ideally supra-gingival , making use of cord redundant. This must be the case with Dr.B’s case otherwise he wouldn’t be able to see the black line if it were sub-gingival. My advice would be to prep only to the gingival margin and not use any retraction cord at all. Of course, good hygiene during temporization is very important but I would steer clear of rubber dams at cementation - they will cause more problems than they solve.

  • Joanne f November 25th, 2008

    Sometimes we see dark stained margins because the patient rinses excessively with high alcohol mouthrinses. This degrades the resin bond and allows bacteria to enter and stain results. Patients should use non alcohol non colored mouthrinses and toothpastes.

  • Mike Stanley, asst. December 2nd, 2008

    I recently saw a technique for removing veneers by way of brief laser exposure. Try a YouTube search. You may be able to remove them, clean with MicroEtcher-type sandblaster and HF etch and recement using the advise above.

  • johnackley@bonadent.com December 3rd, 2008

    Mike is correct Dr Hornbrook has a Youtube video that demonstrates the technique, very slick and very fast.

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