From the Editor

Gerard Kugel, DMD, MS, PhD

Dear Readers,

It seems that each year since our inception, all of us at Inside Dentistry at one time or another turn our attention to a pressing issue involving esthetics, related treatment modalities, and some form of conflict that lies therein. It seems that 2009 will not be an exception.

This month, our cover feature attempts to define or differentiate what the profession has come to discuss as no-prep and minimal preparation veneers. In doing so, we offer an overview of where the veneer modality itself began, how it evolved, and what is now meant today by this terminology.

Marketing Hype vs. Clinical Reality. Information distributed to both patients and dentists about no-prep and minimal prep veneers can sometimes be nothing more than hyped up propaganda. However, we can’t deny that patients today do want to conserve their natural teeth, and many who are savvy about conservative techniques are motivated to ask for treatments that are consistent with a healthier, perhaps even pain-free lifestyle. Patient populations are also driven to maintain an esthetic and youthful appearance, but some information could be misleading. As dental professionals, we owe it to our patients to perform thorough examinations and smile assessments to determine what’s really going to be the best treatment. It’s our responsibility, not an option.

For Bonding, Less Reduction is More Predictable. Our well-respected interviewees make us fully aware in our cover feature that when it comes to veneers, we have come full circle. We began with a no-preparation and minimal intervention approach, progressed to greater and more aggressive tooth reduction that encroached on dentin, and have returned to cherishing a practice of lightly preparing enamel. The research clearly indicates that bonds to enamel have greater long-term predictability than those to dentin. Considering that our minimal intervention goal is to help curtail the re-restoration cycle, it makes sense to continue to preserve as much enamel as possible when designing preparations for veneers. And, fortunately, manufacturers are helping to facilitate a conservative approach by continuing to introduce restorative materials that are coming closer to satisfying clinical and functional demands in terms of strength and thinness, as well as esthetic requirements in terms of color, translucency, and optical properties.

Know What’s Available, and What’s Involved. I have emphasized several of the following points in the past, but in formulating a position statement about what we need to be aware of when it comes to no-prep or minimal preparation veneers, it appears we’ve come full circle in other ways, also. Patient needs must continue to be our priority, and when they are, we will be most comfortable in proceeding with whatever procedures are treatment planned. But to propose anything, we must maintain a current knowledge of available esthetic restorative modalities and materials so that all options can be intelligently discussed and evaluated, not just those in which patients are interested.

We hope you enjoy this issue and find that it broadens your understanding of the conflicts and confusion that surround the concept of no-preparation and minimal preparation veneers in today’s dental practice. We also hope that it enables you to better determine whether either might be appropriate for the cases with which you are presented to provide your patients with the best possible care and optimum esthetic results. Please send us your feedback to letters@insidedentistry.net. As I emphasize each month, your thoughts, opinions, and reactions motivate us to continually improve our clinical content and coverage of the topics impacting our profession. Thank you for reading and for your continued support.

With warm regards,

Gerard Kugel, DMD, MS, PhD Associate Dean for Research Tufts University School of Dental Medicine gkugel@aegiscomm.com P.S. To ensure that you continue to receive all that Inside Dentistry has to offer, please sign up for your free subscription by visiting www.insidedentistry.net. I urge you to fill out and return the enclosed postage-paid reply card if you want to continue receiving Inside Dentistry by mail. Due to rising postage costs, Inside Dentistry will now only be mailed to those who specifically request it. If you have not subscribed, or are not sure when your subscription expires, fill out the card and drop it in the mail to ensure that you don’t miss a single issue.