cosmetic dentistry - beauty & science

special topic _ lithium disilicate veneers I or self-etch composite cements—such techniques are better known in the literature as “conventional”. Full-contour restorations can be created and char- acterised with staining or layered with IPS e.max Ceram ceramic. _Case report Thepatientpresentedtoourpracticewithasim- ple request: “I don’t like the stains on my teeth and I would like to correct the rotated tooth #22 to look like #12”. The examination established that teeth #11 and 21hadstainsmostlikelycausedbyfluorosis,visible under a partially delaminated composite layer, which was previously added by another dentist in an attempt to mask the discoloration. Tooth #22 was rotated with a huge mesial composite filling (Figs. 1 & 2). A seemingly nice and relatively har- monious smile, upon further inspection, revealed a number of composite fillings on the proximal palatal side of the central incisors, which limited the possibility of restoration with veneers on these teeth. After consultation with the laboratory and ce- ramist,wedecidedtouseIPSe.maxPresstoproduce crowns for teeth #11 and 21, with preparation as conservative as possible, and a thin, V-shaped vestibular palatal veneer on tooth #22, which was to simultaneously be rotated to correct and com- pensate for the missing natural tooth structure restored with composite. There was a need for preparation only on the labio-distal tooth surface after removing the mesial composite fillings. A ve- neer was made for tooth #12. After reviewing the composite fillings on the centrals, the teeth were prepared palatally with a supra-gingival finish line and minimal re- moval of the tooth structure. Teeth #12 and 22 were very conservatively prepared, owing to the characteristics of e.max Press materials the advantages and characteristics of e.max Press materials. Temporary restorations were fabricated from composite material and cemented with the spot-etch technique, in order to allow the fit of the defin- itive restoration. Impression taking was done with one stage putty/wash technique usinghighlyaccurateFlexitime Putty and Flexitime Correct Flow materials (both Heraeus; Fig. 4b). The surface of the prepared teethwashealthy,withnatural colour and no discoloration, which allowed us to use the highly translucent IPS e.max Press HT BL1 ingot (Fig. 6). The copings were pressed from lithium disilicate material and fired in a special furnace. Fig. 4a_Conservative preparation on palatal side for pressed crowns. Fig. 4b_Impression with A-silicone (Flexitime Putty and Flexitime Correct Flow). Fig. 5_Ceramic cores for the restorations were made of wax patterns created on stone model in full volume. Fig. 6_Lithium disilicate cores were pressed from HT BL1 ingot. Fig. 7_Superb nature-like optical performance of lithium disilicate e.max system. I 19cosmeticdentistry 2_2012 Fig. 5 Fig. 6 Fig. 4a Fig. 4b Fig. 7