Injectable Composite Veneers: Fast, Affordable and Beautiful

It's not like you need to go get new technology or equipment to do this procedure in your office. If you have Etch and Bond and Flowable, which every office has, you're already ready to go. And then it's not like you've got to go market for new patients. The patients that will want this treatment already exist in your practice. Welcome to the Phil Klein Dental Podcast. In an ideal world, if a patient would like to improve their smile and they are a perfect candidate for veneers, the best way to fabricate those veneers is through indirect dentistry. But the reality is many patients simply can't afford traditional lab fabricated veneers. And without a more affordable option, they do nothing and continue living with a smile they're not happy with. But now there's a solution. With a product called Veneer Now, dentists can offer a beautiful life-changing makeover that's easy to do. completed in a single visit, and well within reach for most patients. Our guest, Dr. Lundon Albrecht, a practicing general dentist from Ohio, shares how this innovative veneer matrix kit allows him to deliver stunning aesthetic results without impressions, no temporaries, no lab work, or multiple appointments. It's all done on one visit. and the system works with any adhesive and composite that you currently use in your practice. It requires minimal adjustments and can also be used for chipped anteriors and peg laterals. Even better, Dr. Albrecht says, you don't have to market this to your community because the demand is already in your practice. This is a minimally invasive, highly profitable procedure that's easy to learn and makes a big impact for both your patients and your practice. Before we bring in our guest, I do want to say that if you're enjoying these episodes and want to support the show, please follow us on Apple Podcasts or Spotify. You'll be the first to know about our new releases and our entire production team will really appreciate it. Dr. Albrecht, thanks for joining us. Thanks for having me. So we're happy to have you on the show, Dr. Albrecht, because you present with a very interesting perspective when it comes to veneers. Most of your patients in your practice cannot afford to have indirect veneer fabrication. And the option of doing it through additive direct composite restorative is a very manual process that requires a lot of artistic ability. It's time consuming and it's not for everyone. And you have to have a lot of patience. And when I say patience, I'm talking about temperament. So you've embraced a different technique, something that really satisfies your patients aesthetically and is very affordable for them and also is very profitable for you. and that's injectable composite veneer so tell us about the general concept of that why you got involved with that and then we'll follow up with the actual procedure of how you do it perfect yeah so i mean that's essentially why i did get into bonding and different types of bonding was that you know you may uh tell a patient they want you know that wants veneers how much lab veneers are and they can't afford it. So then an alternative option for them is some sort of composite bonding. Now, the reason why a lot of dentists don't do composite bonding is that it's time sensitive. It's hard. And so a lot of them spend too much time doing it and then it doesn't become profitable because it's eating up their time. And so Premier... is unveiling this new technique through veneer now which is an injectable matrix that has everything already done for you so you can do composite bonding in uh you know a minute uh everything's done when you say composite bonding dentists are doing composite bonding but you're saying artistically building the tooth up for aesthetics with the bonding exactly yeah yeah because the actual bonding itself if you're bonding a class one in a molar that doesn't you know take a lot of time you're talking about anterior aesthetics yes when you talk about adhesive dentistry you're talking about adhesive uh adhesive aesthetic dentistry just exactly just so we clarify for our audience so we're talking about anterior composite makeovers yeah anterior composites even whether it's a class four like an incisal uh broken fragmented tooth uh whether it's decay um any facial surface on the anterior instead of spending time with an instrument and shaping and pushing the composite incorporating air bubbles and causing stains or this is a matrix that will slide over the facial side of the tooth. and into the inner proximals and then all you're doing is injecting composite directly into it which is going to and then curing it which is leaving a perfectly shaped tooth without you having to spend any of that time yeah now these shells come out of a box right exactly how are they packaged like what teeth come in the system and and what are the sizes yeah so there's um in a veneer box veneer now box there's two packages essentially there's a small medium which is typically the most commonly used size in there you're going to have number five through number 12. so you're getting pre-molar to pre-molar so you can do a full small makeover with you know obviously eight eight teeth and you're going to have multiple sets of those Also in that kit, you're going to have medium to large sizes, which still gets used, but maybe not as much as the small to medium. What about the lowers? Lowers haven't been manufactured yet. That's something that's coming. So right now it's just available for anterior maxillary. Give us an example of what kind of... efficiency this brings. You know, give us a case example where a patient comes in. Before we get into the details of the procedure, tell us about how you present it to the patient and what kind of patient are we talking about? Someone who may not have the resources to go indirect or they don't have the time or they need something right away. Tell us the communication. What's the case presentation look like? What do you say that it would cost them to do? For instance, let's start with a basic single tooth. or number eight nine let's say the eight niner chip what what does that look like well so a single tooth would probably only be done if you were say somebody broke uh you know an edge off a front tooth and instead of just doing a traditional like four surface composite that may take time you could just slide one of these on and inject it and be done in 30 seconds so that would be billing out maybe just a four service composite so that's more restorative side but if it was cosmetic and they didn't like maybe a gap between their teeth or um you know they're they're not perfectly even or the you know some malocclusion or something, what you could do then is do two teeth or four teeth or six teeth or eight teeth. And then what I would tell the patients is, so it's a cosmetic situation. I'd say, yeah, there's two things we can do. We can do traditional lab veneers, and this is how much they are. Or we could do a composite veneer, and this is how much that is. And what I usually tell people to bill out for these or any type of composite veneer is if your lab veneer is, say, $1,000, then your composite veneer, should be $500 or maybe like a little less, like $450. And the reason why is it's amazing how many more people can do that when you offer a composite veneer at half the cost. And typically, like I said, dentists are kind of in a realm where they've done composite veneers. before or composite bonding before and they just didn't have success with it because they got kind of discouraged at how long it took them or maybe what the case turned out like and so they they usually don't even offer their patients the composite veneer option they just say these are the porcelain veneers and then so many patients can't do it and they don't do anything so just being able to offer this because it's so easy literally if you've done a white filling you can you can do a composite veneer now that's how easy this is right so sounds like there's a huge savings of chairside time compared to doing it manually without a template um these out of the box veneer shells that that's called veneer now i'm sure they have all the anatomy built into it so if you're doing tooth eight and nine uh the line angles the contour you can line them up perfectly and and obviously achieve the aesthetics you're looking for rather quickly Exactly. They've already been factored in to give you all the line angles and details. So that's what's taking all the guesswork and the troublesome parts out. So you're basically eliminating the stress. You're just etching, applying your adhesive layer. Now, do you remove any tooth structure on these teeth? So they are made to go directly over. So if you had a tooth that you weren't going to do any reductions on, you could just go ahead and apply one right over. Sometimes I do reduce. It just depends on, again, like what we're trying to do. If one tooth is too facial and I need to kind of bring that back into the smile, then obviously we'll reduce some there. Or if it's a dark tooth, you're obviously going to reduce a little bit more to mask the darkness of that tooth so you don't get show through. Those are all considerations you just got to take in, and every case is kind of different. For a peg lateral, this would be phenomenal. Ideal, ideal. Yes, minimally invasive. You're not doing anything. You don't even have to do anything to that tooth. What you'll do with a peg lateral is whether you hold the back lingual side with just your finger and put a little flowable, basically just build up a lingual shelf so that when you inject the flowable into the veneer now matrix that you don't squirt the flowable out into the mouth. You just need some sort of... Some sort of backing. Lingual barrier, exactly. So you can hold that with your latex or non-latex glove. Yes, exactly. And so you put a glob of composite on the lingual or the palatal because it's upper right now. And then you put the, after you do your adhesive work, you put the shell on and then inject through the hole and the composite fills that matrix. And one of the things you talked about was the fact that you get really good contact with this matrix system. whereas other systems you've used in the past, you haven't been able to do that. Tell us about that. There were other putty mold techniques that you could do where you could inject, you know, flowable into some clear putty. It was the difficult part with that is that the inner proximals didn't ever really turn out great. Where this... has interproximal wings that go interproximal that gives it a really tight seal so you're not getting those overhangs, which is really nice. So it seems like flowable composite would be the best composite to use for this technique in this system, but you're using a stronger body composite rather than flowable. Tell us how you get the flowability of that and you don't get voids and therefore you're benefiting from the strength of that material. So again, the flowable is obviously the number one option just because of the hole that it's made for. But then with all the cases I've done, people would say, oh, with anterior restorations with flowable, do you get a lot of chipping and wear? And again, I think that's just case to case dependent. If people are grinders, obviously there's higher chances of that. i got to the part where i was like well let's see if we can make these even stronger and not use flowable and and so what i did was if you take traditional compules of composite and you heat them up heated composite flows like flowable. When you use heated composite, it comes out as a consistency like flowable. So what I would do is where the hole is in the veneer now matrix, I enlarge the hole and then heat up a compule of composite and then inject it. And now you're getting a veneer that is coming out like flowable, but with the strength of a traditional composite. Yeah. And they have composite systems that are actually comes with a warmer, a composite warmer, and the actual material is designed to be warmed. Yes. Yeah. And that's the beauty with Premier's veneer now. You can use any composite. So if you have a composite that you like, it's not brand sensitive. So this is whatever etch you like, whatever bonding adhesive system you like, and then whatever composite system you like, you're just using this matrix as a tool to efficiently and quickly. and easily and without stress do anterior restorations. Yeah, and that's a phenomenal thing about the warming of composite because this is a perfect example where you want low viscosity on the delivery of it. It was mostly designed for getting down in a deep class 2 box so that you can get that material down there and obviate flowable if you want to because you're warming the composite and in one sweeping motion you fill the whole tooth up. In this case, with this veneer now system, that's a great application for a warm composite. So in addition to the aesthetics that we're all concerned about for the patient, we also have to be concerned about the contact area between the teeth because we obviously want the patient to be able to floss comfortably there. We don't want a food trap being that there's no contact or inadequate contact. So talk to us about the contact area. And also once that... is all polymerized. How do you adjust it if it's necessary to be adjusted? That's what's nice about the matrix is when you try in the matrix first, obviously prior to doing any bonding or etch, you try the matrix in dry just to see how the fit is. And if it slides in, then you could go ahead and proceed with the matrix. Now there's times that the contacts or you're not reducing very much and you're not breaking contact. with the adjacent teeth sometimes in that situation you can cut the wings the interproximal wings off the matrix and then kind of just use the facial side with maybe some wedges but essentially you can get really nice contacts with this matrix and then when you're done after you've cured it you remove that shell I'll always floss it, but I'll use like an interproximal sanding strip or a diamond strip just to really fine tune and make sure there aren't any overhangs or flashes. But this is the best matrix system that I've seen that produces really good contacts. I didn't know there were too many products out there that actually accomplished this. No, this is the only one. Yeah, Coltine had one. Theirs was just a shell that stayed on the tooth, but this one is the only matrix, and it's the only matrix that has interproximal wings built into it. It's just the other way of doing it was the clear putty mold where you would put Teflon tape in between the teeth to form a barrier to not bond all the teeth together, and that didn't provide good. inner proximals because it was just teflon or this is a guided inner proximal with wings so your your contacts are great yeah so how much material is actually being applied into that hole into the matrix yeah if you're not reducing the tooth very much because we are doing a direct veneer at a composite so how thin is that so on those situations if you were just going um you know directly over with with no with no preps, it might be close to 0.3, 0.4 millimeters, very minimal amount. So those are factors to consider if you are trying to go really white. And you just want to make sure that when you do that dry try-in, you'll try it in. And you can kind of even push it and see if you're rubbing anywhere with tooth. And then that'll give you an idea of maybe I need to reduce a little right there to give me a little more clear space. Now, are your patients happy with the aesthetic results? Because you're not going to get what you would get with a Emax or Zirconia where you have that translucency. Again, in many cases, the tooth is barely prepped when you're using this veneer now. But what's the response from the patients as far as what it looks like? Right. So I can tell you right now of all like the veneers I've done, lab veneers and all of the composite veneers, which I have done tons of composite veneers over the years with different, all sorts of brands and everything. I'll tell you one thing, like generalization and all that is that the most finicky patients are the lab vener patients because they've spent so much money that they expect perfection. And sometimes that is the one thing that causes dentists to not do veners. My dad does not. look to do veneers ever because of the headache that he sees that comes with those patients. And so he just doesn't do that. Now with composite veneers, because they are just so grateful to be able to have a treatment that they can afford, they've been ones that have obviously probably wanted to do porcelain that couldn't. They are just ones that are not happy with their smile. So to have... straight white teeth is a huge like win for them that's what they want i don't even think i've had a disgruntled uh composite bonding patient because they're just grateful they're grateful and i love it because it's instant gratification it's a single appointment there's no lab bill so your overhead for this is yeah i'm only asking i was going to ask you about that what does it cost you per tooth and you said you bill 450 to 500 or is that just a ball yeah yeah yeah that's exactly right around there um and basically for a matrix when you break down i think the whole kit might even be a couple hundred bucks and so you're you're maybe five dollars into a a tooth maybe including the composite so your your your profit is basically a hundred percent right well you're working you're working with an adhesive So you have to purchase that. Listen, it's your expertise, Dr. Albrecht, the ability for you to be able to diagnose their situation and ascertain that you could build their aesthetics up to a whole new level, maintain the contact points so they can maintenance this at home and don't get food trapped in there. I mean, there's a lot of considerations you have to... You're responsible for it. Yeah. But the bottom line is it's... Pretty quick. So do you typically do on a patient from 5 to 12? Do you go that whole route? Or do you just do a couple of teeth? Again, kind of depends on the case. But I've done some. It's just two, like eight, nine. And then I've done four. There's times I've done six or eight. I've even added the premolar and done it two times and made it 10. And so there's really, it's case dependent. But the beauty of it is, is that. All of those patients that are doing it are just excited to have it done. And you do it one tooth at a time, right? Because you have to fully cure the matrix. I call it a shell, but a matrix, same thing. So you have to fully cure the matrix with the composite in there, remove the matrix, and then do the tooth next to it and keep moving. Yes. And that's honestly what makes the whole process easier is you're going a tooth at a time. And so, you know, start at, you know, maybe number eight, then do number nine, central, central, then do the lateral, lateral, you know, and kind of move your way back. That's traditionally what I do. But it literally keeps you with minimal stress because you're not worried about trying to do a bunch of things at one time. You're just... Everything's reversible too, right? Yes, totally. You're not doing massive amount of reduction, which we shouldn't be doing anyway at this point. You don't need to take impressions. You don't need to go to the lab. And you've been doing this a long time. For some reason, you fell into this because I think somebody was getting married or something. You told me on one podcast years ago and you had to fix their tooth for photographs and you had this kit that you had. which again, I think it was cold team, but they don't sell it anymore. And now Premier has this more, I think this is a more sophisticated method where you actually remove the matrix, right? Definitely is. And also with those wings, it actually helps with the interpersonal contact. So this matrix, there's none other matrix like this out there. I mean, this is the newest technology for direct bonding for sure. But yeah, I fell into it and it became a game changer for my practice. Just overall, it was one of those things that has been just a blessing really to do. It's great for the patients. It's great for us. It's the fun part of dentistry where you can instantly change somebody's life and instantly see the results. And I have more of a blue collar practice. And that's the beauty is I think that in every practice, it's not like you need to go get new technology or equipment to do this procedure in your office. If you have etch and bond and flow. which every office has, you're already ready to go. And then it's not like you've got to go market for new patients. The patients that will want this treatment already exist in your practice. They're just looking for an answer that they've always wanted. And now that you have it, when you do it, you'll see. You'll be like, oh, composite bonding is easy. I can do smile makeovers now. This is not a hard thing because it's so easy. It's taking the stress out that you're going to actually, at hygiene appointments and recalls, you'll say, hey, if you want, I could add a little composite on that too. Then we can make that one straight so it blends in with the other one. Like, oh, that's great. Let's do that. How much is that? And so once you have the tool in your office, you're going to see a lot more. Yes, they're already there. So how much manipulation do you have to do to the matrix as far as uh cutting it with scissors because i've seen videos and i i recommend everybody to go to premusa.com uh that's premier's dental site they have videos on this Some of them are animated. Most of them, I think, are animated. But they do show you how to use the matrix. Are you doing a lot of manipulation with scissors, Dr. Albrecht, on these? There's times that when you do the dry try-in, that because it's meant to be tight interproximately, you may not be able to get the matrix in with the wings on. And the only other way you would be able to solve that is to break interproximal contact so you can slide the wing in. That's one option. Or to cut the wings. with scissors and then try it in. And that's more of what I typically do with that rather than break the contact if I don't need to. How would you recommend someone who has never done this before to practice and get to the point where they feel somewhat comfortable? Maybe they work on a dental form. What is your recommendation? Yeah, one option is obviously a typodont. Just get a typodont, try it out a little bit. I think Premiere, ideally, I would tell them if they started doing some hands-on workshops, that would be ideal. In the past, that's one thing I've done is shown Dennis how to do them. When you can see it and touch it and feel it, that's the easiest way. But if you can't do that, any type of typodont works. And then just... I remember when I got my first box, I got my box and I was so excited to do it that I just came in and my secretary at the time, I said, you know anybody that needs some teeth? We got to get someone in. I want to try these. And she said, well, my friend's got like a jacked up smile. I was like, call him up, have him come in. So he came in and sure enough, he was in some bad shape. And I was like, hey, let me do this case on you. I just want to see. you know i'm not going to charge him for that i just wanted to practice and that's one way and and we did it on him and i was surprised because i was like this is easy and like my assistant's like what is this is awesome because it's so easy that um like you know i didn't even have an instrument out and no instruments and i was able to do this whole so is there generally no finishing work to be done afterwards So the only thing you, yeah, that's the only thing you'll need is a hand piece with the, you know, and I'll take a, like a red flame diamond, you know, and just go around the margin and then I'll take a flexi disc and I'll do the incisal edges with the flexi disc. I think that's what they show in the video on the premier dental site. Yeah. Fantastic stuff. I mean, listen, you've been excited about these types of tools that can actually save time and also provide the patient with extraordinary aesthetics. at a fraction of the cost of doing an indirect restoration and immediate gratification where they walk out of your office and they're so excited with what you did and they're so satisfied. And I think the word of mouth spreads pretty quickly when you do something like this on a patient. They're telling their friends and all of a sudden they're proud to smile and people are looking at their smile and said, who did that? And they say, wow, Dr. Albrecht has this technique where one visit, You know, I got all this, I got my whole makeover done. So there's something to that. And I think a lot of dentists don't know about it. And they are looking at, you know, additive direct restorative as a major hassle because it's so intensely time consuming and it requires a lot of skill. Right. Exactly what it is. Everything that you just said is one reason why dentists don't do it or haven't done it in the past. And it's because there hasn't been an easy way to do it. And now there is the matrix makes it so simple to do that. Anyone that's done a white filling can do, you know, smile bonding, you know, cosmetic composite bonding now. And so it's it is a game changer and it's a practice builder. And not only that, it's it's convenience. And patients now want everything fast. They want things. They want things done yesterday, and they want to look perfect. And so this is a great option. When they tell their friends, I only had to go one time, and it only cost me this much, they're all sold. Yeah, absolutely. Well, thank you very much, Dr. Albrecht. We appreciate your time. As you follow the cases that you do with this direct restorative procedure, you'll let us know the durability and how long these things are lasting so that we get some data on that. Okay, have a great night, and thank you so much. Thanks for having me.