porcelain restorations
Porcelain restorations can be used to restore, protect and reshape teeth where carefully planned treatment is appropriate. They can make subtle or more significant changes to the shape, size and colour of teeth, while restoring function where teeth have been damaged or lost.
Different types of porcelain restoration serve different purposes. Veneers are bonded to the front surface of teeth and can alter their appearance. Crowns can restore teeth that are more extensively damaged, while bridges can be used to replace missing teeth. Porcelain restorations can also be used in combination with dental implants.
The important question is not simply whether porcelain can achieve the result you want, but whether it is the right approach for your teeth, your oral health and your long-term goals.
What can porcelain restorations achieve?
Porcelain restorations can create subtle and significant changes to the shape, size and colour of your teeth, while restoring damaged teeth or replacing missing teeth.
When might they be appropriate?
If you have healthy teeth which are broken or damaged, porcelain restorations can help restore the appearance and function of single or multiple teeth. They can be used to correct the colour of a single dark tooth, or replace a missing tooth.
When might another approach be better?
Porcelain is not always the most appropriate or conservative treatment option.
If your teeth are crowded, crossing over or have significant discolouration, there may be alternative or complementary treatments that can achieve your goals while preserving more of your natural tooth.
Active tooth decay and poorly controlled gum disease should be addressed before any definitive restorative treatment. For veneers in particular, having sufficient healthy enamel is important for achieving predictable results.
How I approach treatment
I approach any case which involves porcelain with the end result in mind from the very beginning. This means working closely with my dental laboratory to develop an accurate design and plan for your restorations. Together, the lab technician and I consider not only how your teeth will look, but also how they will function together.
This includes planning how your teeth will function in addition to how they look. We use this plan to give you a preview of your smile long before we pick up and instruments. This plan then guides all of the tooth preparation provided, ensuring that the restorations are as conservative as physically possible.
Where appropriate, this plan allows us to preview the proposed changes before definitive treatment begins. It then guides the preparation of your teeth, helping us preserve as much healthy natural tooth structure as possible.
The aim is not simply to create beautiful restorations. It is to create restorations that work with your teeth, your bite and your smile as a whole.
What does treatment involve?
The amount of tooth preparation required for a porcelain restoration depends on the type of restoration we have planned, the condition of the underlying tooth and its position. In some instances, preparation can be very minimal; in others, more extensive preparation is needed.
Veneers will often require less preparation than crowns, although this varies from case to case. Where appropriate, orthodontics can sometimes help create a more favourable starting position and allow us to preserve more natural tooth.
Almost all porcelain restorations will require us to prepare your teeth in some way. The amount of preparation (drilling) varies between the restoration types with veneers often being the most conservative, and crowns being the most destructive. This is why orthodontics can be a great adjunctive treatment when we are considering this treatment option, to allow us to be as conservative as possible.
Porcelain restorations usually require several appointments, with the exact number being dictated by the overall treatment plan. Appointments can be relatively lengthy, particularly when several teeth are being treated.
Local anaesthetic is routinely used on the teeth we are preparing.
As the final restorations are made at a separate location, you will need to have provisional restorations between the preparation appointment and when we fit the definitive restoration. Provisional restorations protect the teeth underneath, whilst providing an indication of the intended shape, and where appropriate, appearance, of the final restorations. It is usual for you to have your provisional restorations for at least two weeks, but in some cases, while we are finalising details such as the impact of your new teeth on your bite and speech, you may need to be in them for longer.
Longevity and maintenance
Porcelain restorations can provide many years of service when they are well planned, cared for and maintained. Their longevity depends on the type of restoration, the condition of the supporting teeth, your bite, oral hygiene and other individual factors.
Restorations can fail in different ways. Porcelain may chip or fracture, the supporting tooth may become damaged or develop decay, or a restoration may become detached. Occasionally, a restoration that has debonded can be recemented, depending on the circumstances.
With veneers, you may also notice staining around the margins over time. This can sometimes be managed with professional hygiene care, although eventually replacement may be appropriate.
It is also important to consider the long term before preparing a tooth.
In some cases, similar aesthetic improvements may be possible through orthodontics, whitening or composite bonding, either instead of porcelain or as part of the wider treatment plan. Once a tooth has been prepared for a veneer, crown or bridge, that tooth will remain committed to restorative treatment in the future. When the restoration eventually needs replacing, the subsequent restoration may require further alteration to the tooth.
For this reason, I believe the decision to use porcelain should be made carefully, with the long-term health of your teeth in mind.
Related treatments
Porcelain is only one part of the treatment toolkit. Depending on your starting point and goals, other approaches may be more appropriate or may work alongside porcelain treatment.
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