Is a Diagnostic Model Necessary for Laminate Treatment?? (No-Prep / Minimal-Prep Laminates)

Hello,

This is Dr. Kim Tae-young, chief director of Barunyoung Dental Clinic in Yaksu Station, Sindang-dong.^^

With the sudden warm weather recently,

perhaps because many people are traveling,

one common reason for wanting laminates is:

‘I wish my teeth were brighter and prettier when I take photos.’

Many patients visit us saying they want laminates for this reason.

During consultations,

we gather various data such as facial photos, tooth axis, smile line, etc.,

and sometimes, we realize, ‘Ah! Creating a diagnostic model for this patient would be helpful for the treatment process.’

When we ask the patient,

‘Before starting treatment, it would be more helpful to create a diagnostic model and then decide on the treatment direction based on it. Would you like to have one made?’

we often get the question,

‘But is a diagnostic model really necessary??’

So today,

we will take some time to explain

when a diagnostic model is needed for laminate treatment,

and whether it's good to have one even for no-prep laminates.

What is a diagnostic model??

Simply put, a diagnostic model is a replica of the patient's teeth, used to create a model showing the final state after the prosthetic is placed.

In the past, impressions were taken with impression material to create plaster models, and then wax was used to sculpt the form.

Nowadays, creating digital 3D models with an intraoral scanner allows for a more intuitive view of the results.

When is a diagnostic model necessary?

The current trend in laminates is

to enable no-prep laminates,

and even if tooth reduction is necessary,

to perform minimal reduction, only as much as needed for the specific area.

For example, with minimal-prep laminates,

if the teeth are well-aligned, only a slight overall trimming is done to make space for the laminate.

Nowadays, laminates can be made very thin, so if there are areas where no tooth reduction was performed, the prosthetic can be made thinner to compensate.

Diagnostic models are needed when:

1. A standard for tooth reduction amount is required.2. The results after laminates need to be previewed.

First, if the tooth alignment or axis deviates significantly from the normal range,

a diagnostic model is necessary.

In such cases, a diagnostic model makes it much easier to explain the treatment, as it allows for a simulation of the post-treatment outcome. Patients can also compare the before-and-after forms, which naturally increases their understanding of the treatment.

‘My teeth stick out too much; I wish they were set back.’

A patient whose front teeth protruded like ‘bunny teeth’

wanted them set back.

This is the patient's tooth model before treatment.

The two central incisors were protruding, and the patient visited us hoping to have them set back with laminates.

In such cases, without a diagnostic model, it is very difficult to determine how much to set the teeth back and how much tooth reduction is required to achieve that.

By using a diagnostic model that predicts the results in advance,

we could show how much the teeth could be set back. If the patient agreed, we could then perform tooth reduction only as much as needed based on the diagnostic model, preventing additional tooth loss.

‘I want to know if it's possible without tooth reduction, and I want to see the results in advance.’

In another case,

a patient wanted laminate treatment for what is commonly referred to as ‘butterfly teeth,’

where the teeth are rotated.

The patient's condition was whether it was possible without tooth reduction.

‘Butterfly teeth’ means

the teeth are rotated, so to align them,

the protruding parts must be set back,

which means those areas inevitably need to be trimmed.

In such a case, explaining what's in my head verbally

has its limitations, and the patient also wanted to see a simulation first, so a diagnostic model was used.

We first analyzed the upper teeth.

The top two images show the patient's teeth before diagnosis.

The bottom two images show the model with the results after diagnosis.

The diagnosis was that it would be possible by simply smoothing the sharply protruding parts of the existing teeth, which are marked in black.

We also analyzed the lower teeth.

Lower teeth are generally difficult to create without reduction because they interfere with the upper teeth during occlusion.

However, the patient did not want so much reduction that they couldn't live normally if the laminates were removed later, so we considered that point in the diagnosis.

Fortunately, there was a small space between the upper and lower teeth, which we decided to utilize.

In this way, in the space where the upper and lower teeth do not interfere,

the minimum thickness can be measured when laminates are placed, ensuring the necessary thickness.

Through 3D scanning and digital work like this,

the before-and-after states can be understood.

‘I want no-prep laminates, but I'm curious how they will look.’

The second reason a diagnostic model is needed is:

‘I want no-prep laminates without tooth reduction in my current state,

but I'm curious if my mouth will protrude

and what the shape will be like.’

No-prep laminates are not always possible,

but they are sometimes possible for maxillary teeth with certain limitations.

However, there may be limitations in tooth shape depending on the existing tooth size, degree of protrusion, tooth shape, gum shape, and bone structure.

Our mouth is very sensitive.

Even a single strand of hair can cause immediate discomfort.

Even if a very thin laminate is attached,

it is perfectly natural to feel awkward at first.

However, to determine if the patient is willing to proceed, considering the degree of difference,

temporary teeth are made based on the no-prep laminate diagnostic model

and tried on.

The red teeth are the existing teeth,

and the diagnostic model is overlaid on them.

Shorter teeth are extended to match the line,

and the remaining teeth are designed with minimal thickness.

At this point, a thin laminate is not always the right choice.

If a patient wants brighter teeth but their existing tooth color is very yellow,

if the laminate is too thin, the tooth color will show through, no matter how bright the adhesive color is. Therefore, the thickness needs to be adjusted to suit the purpose.

Based on this diagnostic model, temporary teeth are also tried on,

and we check the degree of lip support,

and whether the tooth shape and size meet the criteria,

before deciding on the treatment progression.

A diagnostic model is helpful if available,

but not always necessary.

However,

it is sometimes essential to understand the patient's needs,

to preserve the teeth as much as possible during the treatment process,

and for efficient tooth reduction.

Therefore,

we recommend that you consult with the medical staff and proceed selectively if necessary,

depending on your tooth condition for treatment progression.

I believe

there is no identical treatment under the sky.

Even within one person, multiple teeth have different shapes and characteristics, and since the elements each person possesses are so diverse, even if laminate treatment is performed similarly according to existing tooth shape, facial features, lips, smile, gum shape, and skeletal structure, the visible form will appear different.

Therefore, it is necessary to create a tooth shape that suits the patient's oral conditions as much as possible.

After laminate treatment,

the most common things I hear from patients are:

‘I can smile naturally now.’

‘I can smile without covering my mouth now.’

‘I just realized I could smile like this...’

Just as some people's impressions change,

a natural smile seems to create a good impression.

Thank you^^

Frequently Asked Questions

What is a laminate diagnostic model?

A diagnostic model is a replica of the patient's teeth, used to pre-fabricate a model showing the final state when the prosthetic is placed. In the past, plaster models were used, but nowadays, digital 3D models created with an intraoral scanner provide intuitive results.

When is a laminate diagnostic model necessary?

A diagnostic model is primarily needed when a standard for tooth reduction amount is required or when you want to preview the results after laminates. It is especially useful if the tooth alignment or axis is not typical, or when considering no-prep laminates.

Can I see the results of laminate treatment in advance?

Yes, through a diagnostic model, you can predict and simulate the results after treatment. This helps patients better understand the treatment, and allows the medical staff to accurately determine the necessary amount of tooth reduction.

Is a diagnostic model needed for no-prep laminates?

Yes, a diagnostic model is useful even for no-prep laminates. It allows you to check in advance if your mouth will protrude or what the shape will be like, and to experience the fit with temporary teeth, which helps in making treatment decisions.

Does a diagnostic model always result in very thin laminates?

No, a very thin laminate is not always the right choice. Through the diagnostic model, the adhesive color and laminate thickness can be adjusted to suit the purpose, considering the patient's existing tooth color and desired brightness.

Is a diagnostic model always essential for laminate treatment?

No, a diagnostic model is not always necessary. However, it is sometimes essential for understanding the patient's needs, preserving teeth, and efficient tooth reduction. Therefore, it is recommended to consult with the medical staff and proceed selectively if necessary.