Talk with Dr. Thomas Trinkner wrap-up

During a Facebook Q&A session with Thomas Trinkner, DDS, readers submitted questions regarding the DPR technique article "How to provide veneers on a budget" from the November issue. Here's a brief summary of what was touched on.

Dental Products Report: Dr. Trinkner, how did the concept for this type of procedure come about in your office?

Thomas Trinker: i was doing mock ups for veneer cases to show the patient what it could look like. when i popped some of these off, i realized how nice they looked and and in some cases they could better manage esthetics. hence, the idea to bond these back on after polishing as an indirect technique came about.

Dental Products Report: In your opinion, who are ideal candidates for this treatment?

Tom Trinkner: i think the young patient with somewhat small laterals, maybe a small diastema. 14-early twenties. bright underlying color or bleached teeth. the patient that may not have a ton of wear patterns. most important, if it was my little girl to not reduce tooth structure if possible. this is a wonderful procedure for those that may not have the finances to do ceramic. it is very maintainable and easy to redo.

Dental Products Report: One of the dentists who read the article wants to know if this technique works on lower teeth. He says...

"I have a patient who I have completed a nine unit bridge and now she wants to do something about her lowers but doesn't have the money for 8 veneers after paying the upper case. Can I get the longevity needed on lower teeth?"

Tom Trinkner: it can work on lowers if there is room. sometimes we set this up in the orthodontic phase for space issues and they build me the space.

Amanda Nguyen Seay: are you adding some excess composite to allow for a definitive seat or for some that you can finish and feather directly in the mouth.

Tom Trinkner: it could be a wear factor in the long run. it is fast and certainly easy to mock it up and see what it looks like. takes me very little time to do. get your shapes right the first time. if the color and shape are off, pop it off and start over. the teeth only need to be dry. remember you will come back and cement like a veneer i polish them chairside. the variolink is my excess. i tac at the cervical, brush away the excess, floss both sides while my assistant holds the restoration in place. brush the lingual, cure the entire surface.

Dental Products Report: In your practice, who talks with patients about the cost of treatment options? You or a treatment coordinator?

Amanda Nguyen Seay: I like it! a little more control than just doing it directly:)

Tom Trinkner: way more control. lets say you bond direct. etch,bond,apply your composite. color is off. stop. cut it off. re-etch,bond,start over. this you pick your color, dry the teeth, mock up, if the color is off, pop it off and start over. that is what got me doing it. the ease of use and more predictable interproximal management.

Tom Trinkner: i discuss the cost. this is really about time and reading how difficult or easy the patient will be. i like to be fair because it is quick and needs no anesthetic. i am very gentle with tissue. usually 350-650 per tooth. REMEMBER-THIS IS A PRACTICE BUILDER AND GREAT REFERRAL SOURCE.

Dental Products Report: Are there any frequent questions or reservations you hear from potential patients? Sometimes economical options can make people nervous...

Tom Trinkner: certainly if you are looking for esthetic solutions that are very friendly to the tooth ( no preparation) , usually no local anesthetic, and repairability, this has great potential. the cost is minimal for the benefit.

Dental Products Report: Is there any additional advice you would give to dentists in terms of preparing to take on this technique - either in clinical proficiency or in ways to discuss with patients?

Tom Trinkner: no. it is really easy to do. you just need to get good at the mock up part. i use parkell retractors, dry the teeth, place a ball of composite in the color i want, shape it with an intsrument taking my time to get the desired end result. cure it, pop it off when ready. if you have diastemas, they sometimes can break off little pieces. try to remove gently.