Porcelain Laminate Veneers with a New Zirconia Reinforced Lithium Disilicate Material: a Case Report.

Abdullah Tikreeti

Julian Conejo

Markus B. Blatz

Vincent Mayher

Tikreeti, Abdullah, Conejo, Julian, Blatz, Markus B., Mayher, Vincent
University of Pennsylvania School of Dental Medicine, Department of Preventative and Restorative Sciences


There is a wide variety of materials and techniques to restore a non-carious cervical lesions. This presentation describes the integration of chairside CAD/CAM workflow with the lab processed ceramic press system for restoring a non-carious cervical lesions of #1 to #6 with a new zirconia reinforced lithium disilicate veneers.


A 55-year-old female presented to the clinic with chief complain “I need veneers.” Clinical evaluation reveals non-carious cervical lesions on the facial surface of #6 to #11. After a detailed diagnosis, the lesions identified as erosion lesions on facial surface of #8 & #9 and abfraction lesions on facial surface of #6, #7, #10 & #11. A diagnostic (Pre-Op) scan done with an intraoral scanner (CEREC Omnicam, DentsplySirona). A digital wax up generated in Inlab 20 (DentsplySirona) software, then 3D printed and a silicon stent fabricated with PVS impression material (DentsplySirona) and lined with light body PVS (DentsplySirona). Utilizing the Silicon stent a mockup made inside patient mouth with (Integrity Temporary C&B Material, DentsplySirona) shade A2, and evaluated the anatomical shape, esthetic and phonetics, and obtained the patient approval for the prospected final shape and shade of the veneers, then scanned as a bio-copy scan with Omnicam. A minimal veneers preparation done of #6 to #11 using (Dr. Blatz/Dr. Conejo preparation system for CAD/CAM restorations, Brasseler) and then due to a thin biotype gingiva only a 000 Ultrapak retraction cord (Ultradent) soaked in Hemodent hemostatic solution (Premier) packed carefully with gingival cord packer then a final scan done with Omnicam. Then utilizing the bio-copy scan that we obtained earlier a veneers design done in Inlab software and a CAD-Wax milled using CEREC MC XL (DentsplySirona) and the final scanned model is 3D printed. The CAD-Wax veneers used to manufacture the porcelain veneers using a zirconia reinforced lithium disilicate press ceramic system (Ambria, Vita-zahnfabrik). This material comes in 2 transulcency levels (Translucent/High Translucent). Final veneers tried in with try-in paste (5 glycerine-based PANAVIA™ V5 Try-in Pastes, Kurary Noritaki) shade clear and checked the fit, esthetic and phonetics. Then the cementation process started, first we start with the veneers: 1- etched the veneers using 5% hydrofluoric acid (Panavia V5, Kurary Noritaki) for 30 seconds. 2- another 30 seconds with 35% hydrophosphoric acid (Panavia V5, Kurary Noritaki). 3- Sialine (Panavia V5, Kurary Noritaki) applied and left to dry. Then the tooth steps: 1- Tooth surface etched with 35% hydrophosphoric acid (Panavia V5, Kurary Noritaki) and rinse with water then bolt dry. 2- Applied the Panavia V5 into the internal surface of the veneer and placed on the tooth surface. 3- Excess cement removed and flossed. 4- Light cured the cement from the labial and palatal surfaces. 5- Verified occlusion with articulating paper.


Patient was extremely satisfied and pleased with the final shape, color and esthetic of the veneers.


Although there is a wide variety of materials and techniques to restore a non-carious cervical lesions. Porcelain Laminate Veneers are feasible option of restoring the shape, color & esthetic of the anterior teeth that has a non-carious cervical lesions.