Aesthetic Dentistry

copying nature

Biomimetics is the field of science that is dedicated to the study of the structure and functioning of biological systems, seeking to learn from Nature its strategies and solutions and to use this knowledge by applying it in different areas, such as engineering or medicine. Transposing these principles to Dentistry, Aesthetic Oral Rehabilitation involves reconstructing teeth with materials that simulate natural dental tissues, while reproducing their aesthetic, functional, mechanical and biological properties. The aesthetic treatment best known to general public are the porcelain veneers.


Porcelain veneers are the best known aesthetic dental treatment as it is commonly associated with considerable aesthetic transformations of the teeth and the smile. This procedure is today considered the state-of-the-art in aesthetic dentistry, as it allows you to achieve incredible results with a natural appearance like no other (crowns, implants, bridges, etc.). What are the main characteristics of ceramic veneers and why have they come to revolutionize aesthetic dentistry? See below for the answers to your questions.

Minimal tooth preparation

Unlike zirconia or porcelain fused to metal crowns, which involves considerable tooth wear, veneers only require minimal preparation (0.2 to 0.5 mm) on the front part of the teeth, and in some cases may require no prepration at all. This is because they are bonded, not inserted or retained. The approach is therefore ultra-conservative, minimally invasive and tooth-friendly.

Darkened Gums

The darkening of the gums after performing a dental treatment with ceramic crowns on the front teeth is relatively common and yet very unaesthetic and uncomfortable for the patient, which can affect their self-esteem. This appearance of gray, diseased and lifeless gums gives a strange and artificial appearance to aesthetic dental treatments performed with ceramic crowns on the front teeth. In the vast majority of cases, this effect is due to a wrong choice of materials used in the reconstruction of teeth and in the manufacture of ceramic crowns. Learn more about this subject below.

Teeth Whitening

Teeth whitening is the most innocuous and conservative aesthetic treatment you can resort to. This means that no mechanical wear or chemical erosion occurs as a result of performing tooth whitening. What happens in tooth whitening is that the active substance used - 10% or 16% carbamide peroxide - only removes the pigment and nothing else. In the vast majority of cases it presents spectacular results. Learn more about this subject below.


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Which is the ideal ceramic dental veneers? 

The ideal ceramic to be used in dental veneers is either feldspathic or leucite-reinforced glass-ceramic. These two ceramics are characterised by being very similar to the properties - optical, aesthetic and mechanical - of our natural tooth enamel. Contrary to what many marketing strategies advertise trying to sell the idea of advanced technology and innovation associated with better results, feldspathic ceramics are very common and have been used for many years in dentistry, dating their first use to 1938 by the dentist Charles Pincus. The great difficulty in using these ceramics is their manipulation, as they are very fragile before being bonded to the teeth. Thus, many dental technicians and dentists avoid their use, choosing instead ceramics which are easier to manipulate but have inferior aesthetic results, such as lithium disilicate reinforced glass ceramics or zirconia. After bonding, feldspathic ceramic veneers become as strong or stronger than natural teeth. 

How are porcelain veneers bonded? 

Feldspathic ceramic veneers are bonded to the tooth in such a way that the tooth and the veneer become one. It is impossible to detach a feldspathic ceramic veneer from a tooth when properly bonded. The discovery of the best glue (or adhesive system) to bond veneers to teeth dates back to 1955, when Michael Buonocore described the technique that is still in use today, so it is nothing new or technologically advanced. The success of the bonding process depends much more on the rigor and care in complying with the protocols than on the technological evolution used in the adhesive. After being bonded, the veneer and the tooth become more resistant than the sum of their parts, thus forming a single piece that is very similar to a natural tooth, which is also made up of two biologically bonded materials (the enamel on the outside and the dentine on the inside, with the biological glue being called the cemento-dentin junction). 

What can we expect to improve in our smile with ceramic veneers? 

Ceramic veneers can correct many aesthetic and functional problems, but they also have limitations. They are not a panacea for all dental problems, and may even be inappropriate when more conservative solutions are available, such as tooth whitening, or direct composite restorations. Changes in the position of teeth (crooked teeth, crowding and diastemas) can be solved - to a certain extent - with veneers. Changes in the shape, size and volume of teeth, as well as colour corrections can also be treated with ceramic veneers. They are also used in the treatment of severe or moderate tooth wear, whatever its etiology: mechanical (teeth grinding, or bruxism), chemical (bulimia, reflux, excessively acidic diet), or tooth fractures due to accident or trauma. 

How long does a ceramic veneer treatment take? 

A veneer treatment takes an average of 3 appointments. 
A first planning appointment involving a medical history, impressions, photographs, x-rays and the subsequent case study. 
A second appointment with 3 stages: 
Stage 1: test-drive or mock-up or project, in which you can visualise, test and approve the final result before treatment begins. 
Stagw 2: the preparation of your teeth, with minor grinding (0.2 to 0.5 mm). In some cases there is no need for any grinding. 
Stage 3: the moulds for the Laboratory Technician to make the ceramic veneers. 
The third and last appointment corresponds to the bonding of the ceramic veneers to the teeth. 

What type of maintenance do ceramic veneers have? 

Teeth with ceramic veneers behave just like our natural teeth, so their use and maintenance is no different. Daily oral hygiene and regular check-ups every year or every six months with the dentist are fundamental for maintaining the health of the teeth and the ceramic veneers. 

Are ceramic veneers fragile? 

Veneers are only fragile before they are bonded to the teeth, since they are very thin ceramic pieces (0.2 to 0.5mm thick). Once bonded to the teeth, the veneer and the tooth become one and their resistance is equal or greater than that of a natural tooth. 

What types of veneers are there? 

There are different types of veneers, depending on the material they are made of, and according to their size. 
Materials: there are 3 materials that can be used to make veneers: feldspathic ceramics, leucite-reinforced glass-ceramics and lithium disilicate-reinforced glass-ceramics. Feldspathic ceramics and leucite-reinforced glass-ceramics have the most natural results and the best biomimetic behaviour and are therefore the ceramics used for our dental veneers. 
Size: veneers can occupy the entire front part of the tooth and in these cases they are called veneers, or contact lenses. They can also occupy only a part of the tooth, when we want to correct small details without the need for any wear of the teeth, and in these cases they are called ceramic fragments. 

How many veneers should we do? 

We can do only one veneer, or up to 10 or 12 veneers on the same jaw, depending on the aesthetic and functional needs of the treatment.

Why do the gums darken after ceramic crowns are placed on the front teeth?

The darkening of the gums resulting from treatments with ceramic crowns on the front teeth is a phenomenon that is much discussed and debated in the scientific community, and is called the umbrella effect. This effect is often mistakenly associated with the fact that root canal treated teeth have darkened roots. The phenomenon, however, is quite complex and has little or nothing to do with the darkening of the tooth roots. What contributes to a greater degree to this effect is actually an optical phenomenon. Our teeth work optically like flashlights, that is, when they receive light or radiation (from the sun, or from artificial environments) they literally have the ability to emit light. This phenomenon is called fluorescence, and in the tooth the substance responsible for this phenomenon is dentin. Dentin is the second hard layer of teeth, the first and most superficial layer being enamel. For dentin to produce this phenomenon - that of fluorescence - it needs to receive light or radiation. This happens because the enamel, the hard layer over the dentin that is found on the surface of the teeth, is almost transparent, allowing light to pass through and reach the dentin. When we place ceramic crowns on teeth, if we do not use materials that are almost as transparent as enamel, we are preventing the dentin from receiving light or radiation and preventing the phenomenon of fluorescence from occurring. Now it is this phenomenon of dentin fluorescence that makes the gums around the teeth appear bright and alive, especially in the teeth of the upper jaw. Likewise, when this phenomenon is prevented by the use of non-transparent materials like porcelain fused to metal crowns, the gums appear gray or black, lifeless.

How does teeth whitening work?

Whitening is the most harmless and conservative aesthetic dental treatment as it does not involve or cause any wear on the teeth. It is carried out with a substance called carbamide peroxide, which dissolves and removes the pigment accumulated in the teeth over the years, which is responsible for the darkening of the teeth. This gel-shaped substance remains in contact with the teeth, normally overnight and for a period of 15 to 30 days, through the use of small tooth-shaped drips, into which the gel is placed.