Tucson Lumineers & Veneers Dentist

Lumineers

For most patients, Dr. Ryan offers the LUMINEERS No-Prep or minimal prep technique. In a matter of weeks, patients can permanently improve their smiles while preserving their natural tooth structure. LUMINEERS is a non-invasive approach to permanently whiten, reshape, align, and transform smiles without requiring excessive drilling or temporaries.

HOW I STARTED WITH LUMINEERS

First of all, I LOVE the LUMINEER procedure. Starting in the early 2000’s, I performed the “Traditional Veneer” procedure for many years. I always enjoyed the procedure but felt it was too invasive. I had serious ethical issues with removing so much tooth structure for cosmetic reasons.

After many years of struggling with the issue ethically, I began to have patients ask if I did the “LUMINEERS Limited Prep technique.” After some research, I ended up attending extensive training learning how to perform this procedure. These courses, to put it mildly, opened my eyes to a whole new world and completely changed my mindset and outlook on esthetic dentistry.

With the advance of LUMINEER porcelain technology, the veneers could now be made much thinner. This means less removal of vital tooth structure to achieve the same (or better) esthetic result. Not only did this make the procedure less invasive, but, in many cases, made it REVERSIBLE!!!

In my 20+ years of doing LUMINEERS, I’ve never had a patient want me to reverse a case. (Patients usually regret not having done it sooner…) But, it IS a nice claim to make!!

PLANNING A LUMINEER CASE

Through the years, I have honed the Lumineer technique using various tricks and the latest in case planning technology. One of the biggest advancements, in my opinion, is the use of DIGITALLY PLANNED CADCAM MOCKUPS, TRY INS, AND PLANNED Prep & Reduction Guides.

In the old days, we used to take an impression of the patient’s teeth, then physically add/sculpt wax to the cast to create a beautiful display of teeth. Then, that “wax up” would be the starting point to which the veneers were made.

Now, the cast is scanned into a computer and special computer software designs the smile display digitally. From this digital information, I (as the dentist) know what the case is going to look like before I even begin. This gives me tremendous CONTROL and confidence in the overall predictability and outcome of the case. This takes all of the guesswork out of it and actually makes the whole process kind of fun!!!

THEN, from that data, “FORMS” are made which allow me to physically try the case in the actual patient’s mouth using a temporary (but highly esthetic), removable material. From this, the patient can see, in their own mouth, what the case will look like upon completion. They can see the final result before any tooth is touched, changed, or any financial commitment is made toward the case.

We call this, mentioned in the last paragraph, a “TRY IN SMILE” or “MOCKUP.” In all my years doing this procedure, I don’t think I’ve ever had a patient refuse a case after, first hand, seeing the mockup in their mouth. It’s a VERY POWERFUL and IMPORTANT step!!

Ok. Once the Mockup is established and accepted, I give the “green light” to the lab. They, again from the digital data, are able to fabricate “PREP & REDUCTION Guides”. These guides are small, color coded 3-Dimensional forms that I can put in the patient’s mouth. They guide me as to where and HOW MUCH tooth structure I will need to remove (if any?) in order for the lab to have adequate space to fabricate the LUMINEER.

In many cases, from these guides, I found I didn’t have to remove ANY tooth structure. But, it all depends on the patient. If Bugs Bunny walks in the door, tooth structure DEFINITELY will need to be removed or he will end up looking like BUCKY the Beaver!!

I pride myself on achieving natural and proportional results. When cases look TOO BULKY!! I see many Hollywood actors with big, gaudy, teeth, too white and too bulky!! These are probably cases where the dentist didn’t take the time to do a Mock up try in technique. They found out, after it was too late, that they probably should have reduced the teeth to achieve a more NATURAL result.

Coincidentally, if the patient refuses recommended tooth reduction in my office, then at least we will know that at the Mock up stage BEFORE a very expensive lab bill is generated and/or tooth structure is altered.

Yes, I HAVE had to refuse cases where the patient has Bugs Bunny teeth and they refuse tooth reduction. I’ve also refused cases with patients who have unrealistic expectations on how the case will look in the end. Each case is VERY patient specific and everyone must be on the same page at all times. It’s all about doing things the PLANNED and SMART way. I’ve never been a fan of surprises, so predictability is ALWAYS my friend!!

Final LUMINEER Fabrication

OK. So, the case has been Mocked up digitally, tried in physically, accepted by the patient, teeth have been esthetically contoured (if needed?) and the final impression taken and sent to the lab. The next step is LUMINEER fabrication and “try in” of the ACTUAL Lumineers.

So, before anything is permanently cemented, the patient can, again, see what the ACTUAL porcelain looks like in the mouth. I use a glycerine-like material to temporarily try the case in. This is an opportunity for the patient to look and criticize. Any changes can STILL be made at this point to whatever the patient may desire. Many times, at this point, I’ve had to send cases back to the lab (with copious notes) tweaking things at the request of the patient. Keep in mind, also, that I’m a NERD!!! I like things a very specific way. Many times, the patient is satisfied, but I will STILL send the case back because I know something can be done better.

Ok. So once the patient accepts the FINAL Lumineers… and I accept the case, then the final delivery is scheduled. The FINAL DELIVERY is when the Lumineers are PERMANENTLY bonded to the patient’s teeth.

I do this procedure BY THE BOOK. It is quite long and technically sensitive. I often will book 2 1/2 to 3 hours for this appointment. I don’t always use that much time, but I don’t like to feel rushed and I want to do it PERFECTLY.

After Lumineer Delivery & My Thoughts

I have been doing this procedure for 20+ years and I have NEVER had a Lumineer “De-bond” or come off. Very occasionally, I have had some chip or break. But, after 1000’s of LUMINEER units, I’ve become very confident in my “BONDING” technique.

When I complete a case, there should be ZERO gaps, edges, “bellies”, ditches, plaque traps or discrepancy at the margin of the Lumineer. I pride myself on this. The chipping issues that I’ve had are usually due to a patient grinding habit or “using your teeth as tools” habit. I urge patients to consider an occlusal “night guard” when cases are completed, but I don’t make this a requirement.

Overall, the procedure is AMAZING in its longevity, reliability, and ability to raise someone’s esthetic confidence in themselves and the way they are perceived in the world. I have seen literal tears of joy in patient’s eyes, upon final delivery of some cases. Personally, it’s one of the most gratifying procedures I have in my toolbox. There aren’t many other ways (I can think) to significantly change someone’s life in such a permanent and positive way.

Please see the PHOTOS section for before-and-after cases, including Lumineers. When you look at the pics closely, you know its the same person in the before and after shot, but you can see that “spark”… or light of joy in the eyes of the AFTER pic… This SPARK is the reason I’m a dentist. This SPARK is what makes all those years of school worth it!!!!