How to use Variolink Veneer, a Total-Etch Resin Cement

I’ve used a few different materials and techniques when cementing porcelain veneers.  To be frank, I’ve often found it to be frustrating.  Why? Because I don’t use the special veneer cements all that often and there’s a ton of steps.  Mix this with that, then mix some more stuff together and say a prayer.  No thanks.

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Fortunately I’ve found a product that makes cementing veneers easy.  Variolink Veneer (Ivoclar) is a total-etch resin cement.  We need all the bond we can get when inserting porcelain veneers, so total-etch is the way to go.  For a quick review of resin cements, check out this post here.

Variolink Veneer kit. Lots of goodies in here…

A patient presented to my office to replace a fractured composite resin veneer on tooth #8.

I removed the old composite facing, refined the preparation, took the impression and temporized.  This is a post about cementation, so let’s just skip all of those steps for now.  I get back my nice feldspathic porcelain veneer from Marotta Dental Studio.

Beautiful veneer fabricated by Marotta Dental Studio. Notice that the intaglio surface has already been etched buy the lab.

It’s important to ask your lab if and how they will treat the surfaces of your veneers.  Marotta already used a porcelain etch, so I won’t need to do that step.  If your lab does not etch for you, you’ll need to apply 9.6% hydrofluoric acid for a certain amount of time.  There is a lot of variability in the literature about how long this should be, anywhere from 120 seconds to 4 minutes, depending upon your ceramic.

After taking off the temporary, I like to insert the veneer with a try-in paste.  I still have a chance to raise or lower the value of the final result with a shaded cement.  I’ll also check the occlusion to make sure I’m not only hitting right on the margin of the veneer.  This could lead to exfoliation of the restoration and should be avoided.  As you can see in the picture below, I needed to adjust the bite a bit to move that occlusal mark.

Try in pastes are available for the perfect shade match. Also evalaute the occlusion; we don't want occlusal marks at the margin!

I recommend placing a rubber dam to ensure adequate isolation.  We need every bit of bond we can get, so moisture contamination is our enemy.  I’ll also tie some floss around the adjacent teeth to help clean up.

Rubber dam isolation with floss tied around adjacent teeth. This will help remove interproximal cement.

I wash out the veneer and apply phosphoric acid for about 10 seconds.  This does not re-etch the veneer, rather it decontaminates it.  I then apply silane (Monobond-S) and let air dry.  The veneer is now ready to go.

Decontamination of the veneer with etch followed by silane application (Monobond-S).

To prepare the tooth, I clean with pumice (non-fluoride), etch with phosphoric acid and bond (ExciTE).  Now the tooth is ready to go.

Pumice debridement of tooth followed by etch and bond.

Squirt in your selected resin cement shade to the veneer and insert.  It couldn’t be easier!  I like to spot cure for a few seconds and then begin to remove excess cement.  It won’t be rock hard yet but is also won’t be runny.  I follow up with a longer 30 second cure and polish.

Resin cement applied to veneer and inserted.

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10 Comments

  1. Jamie says:

    Hi,
    I have some questions about bonding multiple veneers.
    1. do you bond one at a time or in pairs/groups.
    2. do you still use RD bonding multiple veneers.
    3. what do you use to temporise your veneers?
    4. do you ever have problems when, after bonding one or two veneers, the next veneer will not seat properly?

    Thanks for the blog.

    Jamie

    • Chris says:

      Great questions! I’m still planning on posting more about veneers, but let me see if I can answer your questions here: (1) Pairs is fine. Excess bonding agent and resin should be meticulously cleaned after each insertion, so doing more than two at at time can be tricky. (2) Yes. Rubber dam will save you a lot of headaches. (3) I use a bis-acryl like Integrity or a poly-acryl like Telio. I will allow multiple adjacent units to be connected for added retention. I spot bond them in place with etch and bond. (4) Yes! I hate when that happens. This leads back to your first question. Many times this phenomena is caused by air drying the bonding agent, which then gets blown onto the adjacent tooth, gets cured, and hence why the next veneer wont seat anymore. Very frustrating! I recommend placing the other veneers on the adjacent teeth to cover the tooth surfaces. You can then remove them, clean and place silane, then seat. I’ll write a post illustrating this process with a diagram next week!

  2. noureddine sahraoui says:

    dear collegue.i have with collaboration of patient shade BL1/bleach for 6 upper anteriors,2 centrals as crowns 2 laterals as crowns as well and 2 canines as veneers.my questions are/if i use variolink veneer wich shade should i use?and can i use variolink veneer to cement also crowns as this cement have proper shading in tis case?

    • Chris says:

      Hello! One of the nice things about Variolink Veneer is that you can use try-in pastes that mimic the shade of the final cement. Just tell the lab your starting shade (also known as a stump shade) and your final shade. Then try in the veneers with a try-in paste and see if you and the patient like it. Clean out the paste and try in another shade if you want to. When you find the best cement match, just clean the veneer and the tooth, etch, and bond.

  3. Katie says:

    For what reasons would veneers debond after using Variolink? Should it bond to dentine or would it make a difference if the prep was into dentine? Is it technically bad practice in your opinion, to prepare for a veneer into dentine or can it be inevitable in some circumstances and not necessarily bad practice?

    • Chris says:

      Katie, I don’t think it’s a bad practice to prepare the tooth into dentin. Our bond will be stronger to enamel, but sometimes we need a deeper preparation for a greater shade change, because the tooth is flared to the facial, etc. In these cases, it will be really important to maintain as much enamel on the periphery as possible. Also, good moisture control during bonding will be essential.

  4. Maya J says:

    I had a problem with a patient who needs 10 upper veneers during cementation procedure. All gums started bleeding after applying etchant and couldn’t stop the bleeding not even with chemicals. Any idea about the best way to manage this case?

    Thank you

    • Chris says:

      Hello Maya. My guess is that the patient either (1) has untreated gingivitis and/or periodontal disease, (2) the provisional veneers irritated the gingiva, or (3) the preparations invaded the biologic width of the teeth.
      I would first inspect the provisional veneer margins. We want them to have a smooth, polished finish. Next, replace the provisional veneers and initiate hygiene procedures. If the irritation doesn’t resolve in a week or two, probe the teeth under anesthesia to determine if the preps are too deep apically. If there is an invasion of biologic width, the patient will require crown lengthening to resolve the issue.

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