Veneering Technique Research Articles

Effect of Veneering Technique on Shear Strength of Porcelain Veneered Zirconia (PVZ): Finite Element Analysis

Veneering technique is discussed as one of the reasons for chipping of porcelain veneered zirconia (PVZ) restorations, which impacts their longevity and success. This study aims to evaluate the effect of veneering technique; heat-pressed, and hand-layered, on the shear bond strength of PVZ ceramics through finite element analysis. Six cylindrical bilayer material model configurations were analysed; two types of zirconia, IPS e.max® ZirCad (Z) and Luxen Zr (L) and each veneered with three porcelain types, Shofu Vintage ZR (V), IPS e.max® Ceram (C), IPS e.max® Zirpress (P), with dimensions of (10 mm x 1.2 mm) and (5 mm x 3 mm), respectively. The force for threedimensional model configurations were fixed at 5 kN. The results show that heat-pressed groups (ZP and LP) have slightly higher bond strength value 49.12 MPa and 49.03 MPa, compared to hand-layered groups (ZC, LC, ZV, and LV), measuring 48.87 MPa with 0.5% difference at maximum. Bond strength in MPa underwent variance analysis, revealing a significant influence of ceramic material on mean values (p = 0.0017). Thus, the highest stress concentrations occur at the edges of the load application points, gradually decreasing as the distance from the point of load application increases. Results indicate that heat-pressed technique is better than hand-layered veneering technique due to its effectiveness in strong adhering veneer to the zirconia core.

Evaluation of shear bond strength based on substructure materials and ceramic veneering techniques.

Bilayered restorations have both the strength of the substructure material and the esthetics of the veneer material; however, they should have appropriate bonding between the two materials. This study aimed to evaluate the shear bond strength (SBS) according to the substructure material and veneering technique used in bilayered restorations. The experimental group was divided into four groups (n = 15 per group) based on the substructure materials (cobalt-chromium [Co-Cr] alloy and 3 mol% yttrium-stabilized tetragonal zirconia polycrystal [3Y-TZP]) and veneering techniques (pressing and layering). Veneering was performed with disk shape (diameter: 5mm, height: 2mm) on a substructure using each veneering technique. Shear stress was applied to the interface of the substructure and the veneering ceramic using a universal testing machine. The shear bond strength, according to the substructure and veneering technique, was analyzed using a two-way analysis of variance with a post-hoc Tukey's honestly significant difference test. The failure mode was observed, and the surface was analyzed using a scanning electron microscope and energy-dispersive spectroscopy. The shSBS of the Co-Cr alloy and 3Y-TZP substructure was not different (p > 0.05); however, the pressing technique showed a higher SBS than the layering technique (p < 0.05). The SBS did not differ depending on the veneering technique in the Co-Cr alloys (p > 0.05), whereas the SBS in the pressing technique was higher than that in the layering technique for 3Y-TZP (p < 0.05). In the layering technique, the Co-Cr alloy showed a higher SBS than 3Y-TZP (p < 0.05). In the failure mode, mixed failure occurred most frequently in all groups. Extensive elemental interdiffusion was observed through the opaque layer in the Co-Cr alloy, regardless of the veneering technique. In 3Y-TZP, a wider range of elemental interdiffusion was observed in the pressing technique than in the layering technique. In bilayered restorations with a 3Y-TZP substructure, the pressing technique yielded higher bonding strength than layering. Using the layering technique, 3Y-TZP showed a lower SBS than the Co-Cr alloy. In bilayered restorations using 3Y-TZP as a substructure, the veneering technique and thermal compatibility of the materials must be considered.

Effect of porcelain veneering technique in bilayered zirconia on bond strength and residual stress distribution

The use of all porcelain materials in dentistry has significantly increased in recent years. However, chipping has remained a common problem that affects bilayered zirconia restorations. Bonding between porcelain and the underlying zirconia framework is crucial to the success of the restoration. The bond strength may be affected by such factors as residual thermal stress and the veneering technique. This research focuses on investigating the potential and constraints of materials through an examination of the porcelain veneering technique, particularly hand-layering and heat-pressing. Forty-two cylindrical disc samples of zirconia (n = 7/group) were fabricated in the dimensions of 10 × 1.2 mm (diameter [D] × height [H]). The zirconia specimens were milled from IPS e.max® ZirCad [Z] block and Luxen Zr [L] block (n = 21/zirconia). The zirconia cores were layered with IPS e.max® Zirliner and heat-pressed with IPS e.max® ZirPress to produce a final veneer dimension of 5 × 3 mm (D × H). Conventional layering was performed for the rest of the zirconia cores using IPS e.max® Ceram and Shofu Vintage Zr. The final study groups were Luxen-Vintage (LV), Luxen-Ceram (LC), Luxen Zirpress (LP), ZirCad-Vintage (ZV), ZirCad-Ceram (ZC) and ZirCad-Zirpress (ZP). Five samples were subjected to shear bond testing (SBS) with a universal testing machine with a 5 kN load cell and 0.5 mm/min crosshead speed (n = 5/group). A sample underwent nanoindentation, and another was sectioned using Isomet machine to study the bonding interface. One-way ANOVA was used to run the statistical analyses of the SBS test. Statistical differences were found between ZV with LC and LP (p < 0.05). Residual stress is estimated to be higher in the middle of the porcelain compared with that on the surface and the interface. FESEM imaging reveals portions of visible bare zirconia on Luxen zirconia, whilst crack propagation occurred through voids in all hand-layered groups. Heat-pressed veneering showed comparable but not superior results to conventional hand-layered veneering. Heat-pressed veneering produced similar stress distribution profiles compared with hand-layered veneering.

Interface adhesion on layered zirconia: Effects of the veneering ceramic material and veneering technique.

To evaluate the effect of different veneering ceramics and veneering techniques on the bond strength to zirconia. 3Y-TZP zirconia blocks were sliced into 60 slabs, polished, and sintered. Each slab received one ceramic cylinder (Ø = 3.4mm, 5mm-high), according to the veneering ceramic type (feldspathic-FEL or lithium disilicate-based-LD) and the veneering technique (file-splitting with resin-based luting agent-RC, file-splitting with fusion ceramic-FC, or heat-pressing-HT), which resulted in six groups: FEL-RC, FEL-FC, FEL-HT, LD-RC, LD-FC, LD-HT. After preparation, the samples were immersed in distilled water for 24h before the shear bond strength (SBS) test. The failure modes were classified as adhesive, predominantly adhesive, or cohesive. Representative failure mode images were taken in a Scanning Electron Microscope. The SBS data were analyzed by two-way ANOVA and Tukey's test. Both type of veneering ceramic and technique affected the bond strength. FC led to the highest SBS values. RC and HP provided similar results when compared within each veneering ceramic. Lithium disilicate achieved lower bond strength than feldspathic ceramic when the heat-pressing technique was applied. The most frequent failure modes were predominantly adhesive and adhesive for FEL and LD, respectively. File-splitting with fusion ceramic provided the highest adhesion to zirconia when feldspathic or lithium disilicate-based ceramics were used. The heat-pressing technique for veneering with lithium disilicate significantly decreased the bond strength when compared to the feldspathic ceramic.

STRESS DISTRIBUTION OF MONOLITHIC AND VENEERED THREE-UNIT ZIRCONIA FDPS: A FINITE ELEMENT ANALYSIS.

To evaluate the effect of restoration design on fracture resistance and stress distribu0on of veneered and monolithic three-unit zirconia fixed partial dentures (FDPs) using finite element analysis (FEA). Identical epoxy resin replicas of mandibular second premolars and second molars (to serve as abutments for the three-unit bridges) were divided into four groups (n = 10): monolithic zirconia (MZ) restorations; conventional layering veneering technique (ZL); heat pressed-on technique (ZP); or CAD/CAM lithium-disilicate glass-ceramics (CAD-on). Specimens were subjected to compressive cyclic loading on the mesio-buccal cusp of the pontic (load range 50 to 600 N; aqueous environment; 500,000 cycles) in a universal testing machine. Data were statistically analyzed at 5% significance level with Fisher exact test and Kaplan-Meier survival analysis. 3D models were constructed in accordance with experimental groups. The stress distribution in each model was analyzed and evaluated according to the location and magnitude of the maximum principal stresses (MPSs) using ANSYS so\ware. Specimens from ZL and ZP groups failed at different stages of the 500,000 cycles fatigue, while CAD-on and MZ restorations survived the fatigue test. Statistically, there was a significant difference between the groups (P < .001). The MPS were located under the mesial connector in both monolithic and bilayered three-unit zirconia FDPs. These stresses were found to be higher in monolithic geometries compared to bilayered zirconia FDPs. Monolithic threeunit zirconia and CAD-on zirconia frameworks resulted in superior fracture resistance. Restora0on design significantly affected the stress distribu0on of three-unit zirconia FDPs.

Effect of different finishing and polishing procedures on surface roughness and microbial adhesion on highly-filled composites for injectable mold technique.

To evaluate the effect of different finishing and polishing procedures on surface roughness and microbial adhesion and viability of Streptococcus mutans on novel highly-filled composites for injectable mold technique. One hundred sixty specimens were divided into four material groups: FSF (Filtek Supreme Flowable Restorative), TE (Tetric EvoFlow), GUI (G-aenial Universal Injectable) and GUF (G-aenial Universal Flo). Within each group, specimens were split regarding finishing and polishing (F/P) procedures into: SLD (Sof-Lex Discs), SLS (Sof-Lex Spirals), OG (OneGloss) and PG (PoGo). Surface roughness was analyzed using profilometer (Ra and Rz) and scanning electron microscopy (SEM) and Strep. mutans biofilm formation was analyzed using colony forming unit (CFU) and cell viability assay. Two-way analysis of variance (ANOVA) followed by Tukey's post hoc test were used for comparison among groups, Pearson's coefficient was applied for the correlation between Ra and CFU/ml and all data were presented as mean ± SD. Both materials and F/P procedures affect Ra, Rz and Strep. mutans CFU/ml values (p ≤ 0.05). Considering the Ra and Rz, GUI and GUF revealed lower values, compared to FSF and TE and SLD and SLS revealed lower values, compared to OG and PG. Considering the Strep. mutans CFU/ml and viability, GUI and TE presented lower values, compared to GUF and FSF and SLD and SLS presented lower values, compared to OG and PG. Moderate positive correlation was found between Ra and CFU/ml (r = 0.552). The smoothest surfaces possess GUI and GUF, among materials and SLD and SLS, among F/P procedures. GUI adhered the lowest amount of Strep. mutans, due to the smoothest surfaces. FSF and GUF revealed the highest amount of Strep. mutans, due to bis-GMA, bis-MEPP and TEGDMA in their composition. The findings of the present study may be beneficial for the proper selection of highly-filled composites and an adequate finishing and polishing procedure when performing the injectable mold composite resin veneer technique.

Partial Ceramic Veneer Technique for Challenging Esthetic Frontal Restorative Procedures

Frontal darkened teeth have shown to be one of the most challenging treatments for esthetic dentistry in recent years. This case report, along with a 30-month follow-up, describes the application of a partial ceramic veneer, restricted to the mid-cervical third region, made in the upper left central incisor darkened by trauma. The procedure consisted of maintenance of the entire incisal face, as well as esthetic and morphological rehabilitation of the smile line with veneers and ultra-thin partial ceramic veneers. The planning process was thoroughly elaborated by photographs, study models, a virtual smile designed, diagnostic waxing, and reproduction in the patient's mouth through mock-up. Following, dental home bleaching, esthetic gingival contouring, and minimally invasive tooth preparation were performed. Two types of glass ceramics (lithium disilicate and feldspathic) were used in different regions due to the peculiar characteristics of resistance, finishing, and polishing. According to the present case report, preparing a cervical partial ceramic veneer is an innovative, viable, and safe approach to maintaining the incisal portion of the tooth preserved and setting a detailed tooth morphology/color. The application of partial ceramic veneer provides incisal edge preservation and simplifies the reproduction of the adjacent tooth characteristics, avoiding multiple esthetic appointments.

Effect of Different Veneering Techniques on the Fracture Resistance of Bioceramic Lithium Disilicate Ceramics Crowns

Aim: The effect of three different veneering techniques (layering, press-over, and CAD/CAM techniques) on the fracture resistance of lithium disilicate crown (LDC). Material and Methods: Thirty lithium disilicate crowns were adhesively cemented on the standardized Epoxy die. LDC was fabricated according to the veneering materials and techniques into three groups (n = 10): group (LV) layering veneering technique, group (PV) pressed veneering technique, and group DV (CAD/CAM) technique. The specimen was artificially aged through dynamic loading and thermocycling. All specimens were tested for fracture resistance using compressive load. Descriptive statistics of frequency distribution mean and standard deviations were calculated and compared across different groups. ANOVA was used to evaluate the effect of the veneering technique on fracture resistance. Results: The highest load was demonstrated in the DV group (1057.26762±97.04401 N) and the lowest load was found in PV group (762.41229±102.56927 N). Similarly, the highest fracture resistance was observed in group DV (14.65171±1.34484 MPa), and the lowest was found in group PV group (10.56558±1.42141 MPa). Mean values of maximum loads and fracture resistance in veneers fabricated by digital, pressed, and layer veneering techniques showed a significant difference. Conclusion: The CAD/CAM veneered monolithic lithium disilicate crowns demonstrated superior fracture resistance compared to the lithium disilicate crowns fabricated by over-pressing and layering techniques.

Three-dimensionally printed facial prosthesis with a silicone veneer technique: A clinical report.

Digital technology has revolutionized the acquisition of patient data and the fabrication ofprosthetic replacements for extraoral defects. This clinical report illustrates the use of a newtechnique which allows the digital creation of an acrylic resin framework which is then veneered with silicone to create an esthetic prosthesis in less time and with less patient discomfort.

Effect of Different Veneering Techniques on the Mechanical Failure of Tooth-supported Veneered Zirconia Crowns: A Systematic Review

Effect of Different Veneering Techniques on the Mechanical Failure of Tooth-supported Veneered Zirconia Crowns: A Systematic Review

Digital Veneering Techniques for Zirconia Implant-Supported Single Crowns-Bond Strength and Clinical Application.

To evaluate the shear bond strength (SBS) of different digital veneering techniques for zirconia and to critically discuss its suitability for application in single-implant prosthetics. A total of 112 square-shaped zirconia specimens were provided with four different veneering materials (n = 28 per group): a glass-ceramic (group GLA), a feldspathic ceramic (group FEL), a polymer-infiltrated ceramic network (group PIC), and a resin nanoceramic (group RNC). Discs in group GLA were sintered onto the core material, whereas all other specimens were adhesively connected. In each group, 14 specimens (GLA0, FEL0, PIC0, RNC0) were subjected to SBS testing before thermocycling, and the other 14 (GLA1, FEL1, PIC1, RNC1) were tested after thermocycling (10,000 cycles). Data were analyzed by applying SPSS software (P < .05). The surfaces and fracture patterns of the specimens were examined using scanning electron microscopy (SEM). Mean SBS values ranged from 14.09 ± 3.87 MPa (RNC1) to 40.82 ± 4.91 MPa (GLA0). Group GLA presented higher values than all other groups (P < .001). Groups FEL, PIC, and RNC showed no statistically significant differences between them. SBS decreased after thermocycling, but no significant impact was found. Every group exhibited a characteristic failure mode. All digital veneering techniques sufficed to present clinically acceptable SBS values and might be viable alternatives in implant prosthetics. However, some have yet to demonstrate their long-term clinical suitability. At present, lithium disilicate-veneered zirconia abutments and monolithic lithium disilicate hybrid abutment crowns seem to present a proven and reliable restorative option.

A Comparative Evaluation of Shear Bond Strength of Ceramic Fused to Metal Fabricated using Veneering and Pressable Techniques–An In Vitro Study

A Comparative Evaluation of Shear Bond Strength of Ceramic Fused to Metal Fabricated using Veneering and Pressable Techniques–An In Vitro Study

Impact of the Veneering Technique and Framework Material on the Failure Loads of All-Ceramic Computer-Aided Design/Computer-Aided Manufacturing Fixed Partial Dentures.

Objectives: Zirconia (Y-TZP) ceramics are considered as posterior fixed partial denture (FPD) materials; however, their applications are limited due to chipping. The use of monolithic lithium disilicate (LiDi) glass ceramics in posterior FPDs can be advantageous. This in vitro study aims to compare the loads until failure of posterior Y-TZP-FPDs and LiDi-FPDs before and after aging.

Evaluation of the Sealing Ability of Direct versus Direct-Indirect Veneer Techniques: An In Vitro Study.

Backgrounds Marginal discoloration, microleakage, wear, and marginal fractures are all prevalent problems with composite veneers, and this scenario leads the esthetic outcome to deteriorate with time, resulting in patient discontent. Aim of the Study. The study's goal was to determine the marginal sealing ability of composite laminate veneers when employing two types of veneer techniques: direct and direct-indirect veneers, as well as two types of composite resin: nanohybrid and microfilled composite resin restorations, using dye penetration method. Materials and Methods In this study, forty extracted human teeth were utilized. Following a standardized veneer preparation on the labial surface of the teeth, they were separated into two groups of 20 teeth each, using the following composite application techniques: group A: direct veneers and group B: direct-indirect veneers. Following that, each major group was separated into two subgroups of ten teeth each, based on the type of composite employed: subgroup 1 used nanohybrid composite resin, while subgroup 2 used microfilled composite resin. All of the samples were kept in distilled water, thermocycled, and soaked in 2% basic fuchsine dye. These specimens were sectioned and examined under a stereomicroscope for dye penetration at the gingival margin. The data was analyzed using independent T-tests using SPSS 22. Result Using direct-indirect veneer technique with nanohybrid composite resin material resulted in the most negligible dye penetration at the gingival margin, while using direct veneer technique with microfilled composite resin material resulted in the maximum dye penetration. For both composite materials, gingival microleakage was lower when using the direct-indirect veneer technique than when using the direct technique, and the difference was statistically significant (P < 0.05). In both techniques, gingival microleakage was lower with nanohybrid composite than with microfilled composite, and the difference was statistically highly significant (P = 0.001). Conclusion The sealing ability of the gingival margin of tooth/composite interface is better when applying direct-indirect veneer technique with nanohybrid composite resin than that of direct veneer technique with microfilled composite resin material.

English

BACKGROUND The purpose of this in-vitro study was to compare the colour stability and bond strength of zirconia-based ceramic restorations after hydrothermal aging using conventional layering, heat-pressing, and multilayer veneering techniques. METHODS One hundred twenty specimens’ core (15 x 10 x 0.7) was fabricated from A2-shade zirconia CAD-CAM blocks (IPS e.max ZirCAD). Specimens were divided into 4 groups for veneering (N = 30): [(layering group (L), IPS e.max ceram), (heat – pressing group (P), IPS press), and multilayer group, IPS e max Cad for 2 different types of cement (cemented with RelyX U200 (M1) and PANAVIA SA (M2))]. Aging was performed for (5 - 55°C, 5000). Colour coordinates before and after aging were measured to calculate colour differences (ΔE00). The shear bond strength test was performed with a universal test unit. The data were analysed using the analysis of variance (ANOVA) and Tukey’s Honest Significant Difference test (alpha = 0.05). RESULTS Significant differences were found between the groups in bond strength (P &lt; 0.001). Group M1 had the highest bond strength while Group L had the lowest bond strength. In terms of ΔE00 values, there were significant variations between the groups (P &lt; 0.001). Group M1 had the highest colour stability, while Group M2 had the lowest colour stability. CONCLUSIONS The method of fabrication had an impact on the power of the bond between veneering ceramic and zirconia, as well as its colour stability. The restoration fabricated by a multilayer technique was cemented by resin cement (Rely X U200 Automix) which was found to be more resistant and colour stable. KEY WORDS Veneers, Heat-Press Technique, Bond Strength, Colour Different, Hydrothermal Aging.

Effect of three different veneering techniques on the stress distribution and in vitro fatigue behavior of core-veneer all-ceramic fixed partial dentures.

Background. The present study aimed to evaluate the influence of the veneering technique on the tensile stress distribution and survival of full-ceramic fixed dental prostheses (FDPs). Methods. A three-dimensional model of an FDP was modeled on a second premolar and a second molar with a pontic between them for finite element analysis (FEA). The groups were divided according to the veneering technique: conventional stratification, rapid layer, and CAD-on techniques. A mesh control test determined the number of elements and nodes. The materials’ properties were attributed to each solid component with isotropic, homogeneous, and linear elastic behavior. For the in vitro fatigue test (n=30), the FDPs were cemented on dentin analog abutments and submitted to 2×106 mechanical cycles (100 N at 3 Hz). Results. Maximum principal stress showed that the connector between the pontic and the second molar concentrated higher stresses, regardless of the techniques: Rapid layer (6 MPa) > CAD-on (5.5 MPa) > conventional stratification (4 MPa). The conventional stratification technique concentrated high stresses at the interface between the framework and veneering ceramic (2 MPa), followed by the rapid layer (1.8 MPa) and CAD-on (1.5 MPa) techniques. The crowns fabricated using the rapid layer and CAD-on techniques exhibited a 100% survival rate, while the conventional stratification group had 0% survival. Conclusion. Even with similar stress distribution between the veneering techniques, the conventional stratification technique was more prone to failure under fatigue due to higher defects incorporated than CAD-on and rapid layer techniques.

Anterior teeth rehabilitation with direct resin composite veneer using multiple layering technique: A case report

Cosmetic veneer has become a popular option for patients seeking to improve aesthetic in their smile. The procedure can be done through a direct or indirect technique which differs in term of material used and laboratory involvement. Despite producing a better aesthetic result than its direct technique counterpart, high-cost treatment, multiple visit requirement and invasive nature of tooth preparation are proven to be a stumbling block to the patient in some cases to choose indirect technique. Therefore, direct composite veneer technique can be offered due to its low costing and conservative concept which advocates more tooth structure preservation. This case report is about direct composite veneer for anterior teeth rehabilitation and its simple and conservative protocol.

Direct restorative approach with composite resin in a discolored tooth

Aim: This case report aimed to discuss the clinical sequence and the indications of the direct veneer technique with composite resin to mask a discolored tooth. Case report: A 18-year-old male patient attended a Dental School for treatment of the maxillary central incisors. During the initial examination, the patient reported a dental traumatism in childhood fracturing both teeth. Tooth 21 had already been endodontically treated, and the patient complained of the darkened color, while tooth 11 had been fractured for a long time. Results: Poor class IV composite resin restoration was found, showing rests of endodontic material on tooth 21 and class IV dental fracture on element 11. The elements were cleaned, restorative materials were removed and composite resin veneers were made using a silicone guide technique. Finishing and polishing were performed in the next session, reproducing some of the peculiar characteristics of young teeth, consistent with the patient's age, such as macro and microtextures. Conclusion: The use of direct veneers in composite resin proved to be efficient to restore the aesthetics of darkened and fractured teeth, restoring aesthetic satisfaction through the transformation of the patient's smile.

Effect of Artificially Accelerated Ageing and Different Mouth Rinses on Color Stability of Veneered PEEK Crowns

Statement of problem:Veneered polyetheretherketone(PEEK) is a recent alternative choice for fixed dental prostheses.There is a lack of data about the color stability of different veneering composite techniques of CAD/CAM PEEK cores. Purpose:To verify the effect of thermocycling and different mouth rinses on color stability of CAD/CAM composite versus conventional nanohybrid composite veneered PEEK crowns. Methods:Forty-two duplicated epoxy resin dies of prepared mandibular first molar to receive ceramic crown were fabricated.42 CAD/CAM PEEK cores were fabricated and divided into two groups(n=21)based on the veneering technique;group(C):nanohybrid crea.lign composite veneered PEEK cores and group(H):HIPC veneered PEEK cores. Each group was subdivided based on mouth rinse into 3 groups(n=7):Listerine-alcohol free, Hexitol and Distilled water.The color at baseline, after thermocycling equivalent to clinical 6 months service and 1-week immersion in mouth rinses were measured utilizing a spectrophotometer.The data were statistically analyzed using ANOVA,pair-wise Tukey’s post-hoc and student t-tests to reveal the significance between groups(P ≤ 0.05). Results:All specimens showed visually unperceptible color differences after thermocycling and immersing in mouth rinses(∆E* 0.05). Conclusions:Although visually nonperceptible,HIPC or nanohybrid composite veneered PEEK crowns showed a color difference after thermocycling and immersion in different mouth rinses.

Composite veneers: The direct-indirect technique revisited.

This article provides an update on the direct-indirect composite veneer technique. Composite veneers have long been used as a conservative and esthetic treatment option for anterior teeth. While they are generally performed using a direct technique, there has been renewed interest in the direct-indirect composite veneer technique because of its advantages and broad indications for restoration of tooth color and morphology. In the direct-indirect composite veneer technique, the selected composites are initially applied on the tooth using a layering approach, without any bonding agent, sculpted to a primary anatomic form with slight excess, and light-cured. The partially polymerized veneer is then removed from the tooth, heat-tempered, and finished to final anatomy and processed extra-orally before being luted. Advantages of this technique include enhanced physical and mechanical properties afforded by the tempering process, unrivaled marginal adaptation, enhanced finishing and polishing, and the ability to try-in the veneer before luting, enabling a shade verification and modulation process that is not possible with the direct technique. The direct-indirect approach also affords enhanced gingival health and patient comfort. This article reviews the direct-indirect composite veneer technique, and outlines critical steps and tips for clinical success. The direct-indirect technique for composite veneers combines advantages of the direct composite placement technique with those of the indirect veneer technique, including operator control, single-visit fabrication and delivery, increased material properties, and excellent esthetics.