Photos provided by Gary Jackson.

Bonded and Cemented Porcelain Offers Options for Patients
BALTIMORE, MD - Porcelain veneers and crowns have emerged in recent years in terms of both strength and durability, and may be the best option for your patients, according to a speaker here. “We live in an impractical world, so we have to come up with practical solutions for our patients,” Christopher Hooper, DDS, told the audience at Dental Learning course. The dentist’s job is helping his or her patients evaluate risks, benefits, treatment options, and costs compared with the value involved in a better smile. Dr. Hooper began his discussion by reviewing the indications for veneers, noting patients with staining, multiple fractures, patients with multiple diastemas, and patients looking to improve their general appearance. Preparation Pearls Dr. Hooper stressed including the incisal edge in the preparations, and he added, “rarely do I do 6 veneers in front, if I can’t do it with 4, then I do 8 or 10.” This eliminates the undeveloped buccal corridor appearance commonly found with a “six veneer case.” He noted that the preparation should be a miniaturized version of the final restoration, “not a miniature of what you start with.” He urged the attendees to “visualize the end result of what your restoration is going to be, using the wax-up and diagnostic photographs as necessary to visualize how the crowns are going to look.” One should prepare the teeth until he or she can visual the end result. Discussing impression techniques, Dr. Hooper suggests striving for smooth, crisp margins, with adequate retraction. He said the goal is to have a clean, dry preparation and to use predictable impression materials. “We like our impression material to be hydrophilic, accurate, with high tear strength and dimensionally stable,” Dr. Hooper said. He noted that 3M’s Impregum Penta Soft Quick-Step features excellent flow properties to capture fine details for precise impressions. He said this product provides a medium body that is hydrophilic, and dubbed it a “must buy product.” Another option is 3M ESPE Lava-COS digital impression system. He said this 3D video capture system enables one to take digital impressions, capturing all the data chairside with the ability to instantly determine if indeed enough reduction has been accomplished. Restoration Options Dr. Hooper noted that there are myriad indirect restorative options available, from veneers to ceramic inlays and onlays to Empress veneers and crowns to LAVA crowns to full zirconia restorations. Each has advantages and disadvantages and all are necessary for a contemporary full service practioner, he said Dr. Hooper discussed 3M’s Protemp Plus Temporization Material, which is the first bis-acryl material to include a new generation of fillers that offer improved strength, handeling, and polishability. “One of the best things about it is it has high fracture toughness,” Hooper said. “It is also quick setting, finishes easily, and is available in multiple shades.” He also mentioned the Protemp Crowns, which, he said “is a great option for emergency patients and when a quick, well-fitting provisional is needed.” Cementing Restorations Dr. Hooper said that properly cementing restorations is a vital part of the treatment procedure, and it deserves careful attention. Hooper said he likes 3M’s RelyX Veneer Cement, a totally light cured system designed exclusively for veneers. “I like the shade selections, and it is simple to use and clean up,” he said. For full coverage restorations that do not require bonding for strength, he uses Rely-X Luting cement in the easy-to-use clicker from 3M ESPE. For Empress inlays, onlays, crowns, and other all ceramic systems that require bonding, his cement of choice is 3M Unicem II with the automix tip. It is dual cured, self andhesive, requires no etching or bonding, and is easy to remove the excess. Dr. Hooper said he feels this is another “mustbuy” product.

Christopher A. Hooper, DDS
Christopher A. Hooper, DDS, is a magna cum laude graduate of the Medical College of Virginia School of Dentistry, now known as Virginia Commonwealth University. He also completed an Advanced Education in General Dentistry residency at the University of Missouri at Kansas City School of Dentistry. He is an associate clinical professor at Virginia Commonwealth University School of Dentistry and is a member of the American Prosthodontic Society, the American Academy of Fixed Prosthodontics, the Academy of General Dentistry, the American Dental Association, Virginia Dental Association, and TDA. Dr. Hooper is committed to providing specialized education on cosmetic dentistry, functional esthetics, fullmouth prosthetic reconstruction, and treatment planning options for the difficult-to-treat occlusal patient as well as the demanding esthetic patient. He maintains a private practice in Virginia Beach emphasizing complete restorative esthetic dentistry, and he lectures internationally. Dr. Hooper Disclosure: Speaker for 3M ESPE.

Dental Learning