Thanks for explaining you current smile and its problems - but it is great that you have the easiest kind of smile to improve with porcelain veneers. The result will be awesome. You will be thrilled! Back to your question - yes, after 20 years there are some veneer cases that need to be re-done. This is due to the porcelain wearing out or other functional use problems. But this isn't the case for all veneer patients. I did several full veneer cases in the 80's that are still beautiful and don't require anything new or have need to be re-done. You may be one of these cases.
I do understand your concerns and it's natural to be kind of confused with the differing opinions that you will hear. I hope I can help you understand the differences and help give you the best advice for the goals you listed - natural, lasting & painless. Porcelain veneers is your best option. Saying that, not all porcelain veneers are the same. If you chief concern is tetracycline stains and your teeth arrangement (orthodontic relationship) is already very good - then very thin porcelain veneers will be perfect for you. With thin veneers, your dentist will make small and minor preparations to your existing teeth to support the new porcelain that will mask your tetracycline. This will be the best of all worlds for you. Very little discomfort (if any), a very strong and long lasting smile that is both beautiful and natural. I wish you the best with your new smile!
Thanks for including pictures on your smile. The docs recommending veneers or 3/4 crowns on your peg laterals are really saying the same thing - although the terms used make it sound different. The good news is that the porcelain veneers need very little tooth preparation (not none, but a very small amount) and the results will look lifelike. You will be really happy and have a long lasting result. The doc recommending bonding on 6 teeth, must be seeing something not visable on the pictures you included. If you whiten you teeth 1st, and really like the teeth surrounding your peg laterals, then restoring the pegs only is the correct choice for you. Wish you the best!
Both porcelain and composite (bonding) are restorative materials that mimick natural teeth. Of the two, porcelain is both stronger and in most cases, has a more lifelike appearence - which is porcelain's superior qualities. On the other hand, composite (bonding) is a fantastic material for esthetic restorations. Bonding is typically more often used on partial coverage fillings. Composite is contoured free-hand and using this material requires your dentist to have advanced training. With this advanced training, your dentist can use composite to even create a full veneer that will look great. Composite is one of the very best restorative materials in dentistry. To make everything make sense - porcelain is used by a dentist and a lab technician to create the very best veneers possible - both in cosmetics and strength. Porcelain veneers require an impression, temporary veneers, and a 2nd appointment. During the 2nd appointment you will get your real porcelain veneers.
Minor reshaping is common on crowns and not a problem in most cases. If removing some of the 'over roundness' helps the new crowns match you existing teeth, then yes reshaping is the best solution. Your dentist can easily manage this and polish the porcelain to a high gloss again. Of course, some additional concerns apply to metal based crowns - although the great majority of anterior crowns are all-ceramic in 2011. The only problem is if the new crown needs 'extra' porcelain to match the surrounding natural teeth. In this situation, the crown needs to be removed and remade. I would ask your dentist about your new crown and have him/her evaluate your concerns. I'm sure you will be happy in the end by honestly discussing the issues you have with th shape of the new crown.
