Layered e.max Veneers and Onlays for Severely Worn, Yellowed Teeth

What was the patient’s concern?

This Bedford Dental Group patient had severely worn, thin enamel that made the teeth look yellow and the smile look older.

“My smile makes me look older and distressed.”

What did the examination find?

Dr. Daniel Naysan’s examination found a worn-down bite (occlusion) and some areas of tooth decay that the patient had not mentioned. The wear had reduced the teeth enough to change how the upper and lower teeth came together. Dr. Naysan removed the decay and incorporated it into the preparation of the teeth for their new restorations.

What options were considered, and why porcelain veneers?

Dr. Naysan considered crowns for this case and ruled them out: crowns would have meant removing more tooth structure, and he preferred the more conservative preparation that veneers allow. The problem here was lost tooth structure and lost bite height rather than color alone, so the plan paired 20 veneers with four onlays that restore the height of the bite.

How was the treatment carried out?

Dr. Naysan completed 24 restorations, 20 veneers and four onlays, in two main visits over about three weeks. He planned the function of the bite alongside the look of the smile, then prepared the teeth conservatively from a mock-up and placed provisional restorations the patient wore and gave feedback on. Beverly Hills Dental Lab made the final restorations in layered e.max, a lithium disilicate ceramic, in shade 0M2. See the full porcelain veneer process.

What made this case difficult?

Dr. Naysan planned the bite as carefully as the appearance of the smile, and he reports that this planning gave the case a predictable outcome and a good long-term prognosis.

What was the result?

Raising the vertical dimension of occlusion, the height of the bite when the teeth close, improved both how this patient’s teeth function and how the smile looks. Dr. Naysan notes that restoring that lost height also gave more support to the lower third of the face.

How long will it last, and what upkeep does it need?

Dr. Naysan expects the layered e.max veneers and onlays in this case to last about 20 years, with an evaluation every six months. Lifespan varies from patient to patient with home care, bite forces and regular dental visits. Read veneer aftercare guidance.

How long did the treatment take?

This 24-unit veneer and onlay case took two main visits over about three weeks at Bedford Dental Group in Beverly Hills.

Is this treatment right for you?

Veneers with onlays to raise the bite suit someone with a worn-down, deep bite and heavily worn enamel that has left the teeth looking yellow. Someone whose teeth are discolored but not worn, with a healthy bite, would not need onlays or a bite raise and may be a candidate for a smaller treatment.