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,” Christo-
pher 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 miniatur-
ized version of the final restoration, “not a miniature
of what you start with.” He urged the attendees to “vi-
sualize 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 sug-
gests striving for smooth, crisp margins, with adequate
retraction. He said the goal is to have a clean, dry prep-
aration and to use predictable impression materials.
“We like our impression material to be hydrophilic,
accurate, with high tear strength and dimensionally sta-
ble,” Dr. Hooper said. He noted that 3M’s Impregum
Penta Soft Quick-Step features excellent flow proper-
ties to capture fine details for precise impressions. He
said this product provides a medium body that is hydro-
philic, and dubbed it a “must buy product.”
Another option is 3M ESPE Lava-COS digital im-
pression 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 re-
storative options available, from veneers to ceramic in-
Dental Learning
lays 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 contempo-
rary full service practioner, he said
Dr. Hooper discussed 3M’s Protemp Plus Temporiza-
tion 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 mul-
tiple 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 restora-
tions 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 de-
signed 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 in-
lays, 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, re-
quires no etching or bonding, and is easy to remove the
excess. Dr. Hooper said he feels this is another “must-
buy” 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 Educa-
tion in General Dentistry residency at the University
of Missouri at Kansas City School of Dentistry. He is
an associate clinical professor at Virginia Common-
wealth 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, Vir-
ginia Dental Association, and TDA. Dr. Hooper is committed to providing
specialized education on cosmetic dentistry, functional esthetics, full-
mouth 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.
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