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Dental Tribune Middle East & Africa Edition

Crowns VS Veneers All the way to creating esthetic Reconstruction of aesthetic & its functionality in combined (Crowns-Veneers) case. Introducing the Dental Lab Tribune highly anticipated section which is part of the Dental Tribune International Publishing Group, composed of the leading dental trade publishers around the world. Its combined portfolio includes more than 100 trade pub- lications that reach over 650,000 dentists in more than 90 countries in 25 languages. It is highly important to recognize the im- portance of the Dental Laboratory and its Dental Technicians who play a vital part of any Dental Team. It is the place which mixes science with art, the backbone of any Dental Clinic much needed in providing the perfect smile as end result. Dental Lab Tribune will be entirely dedi- cated in providing the latest news, state- of-the-art research & developments, prod- ucts and education with special focus on developing further Dental Laboratories and the already skilful Dental Technicians. Working together with world leading Den- tal Professionals, Dental Tribune Middle East & Africa will be delivering the much needed information to its readers. As part of the Editorial Board, together with my colleagues we intend to keep Dental Lab specialists informed of the latest develop- ments, events and advances in both gener- al and specific Dental Lab topics in an eas- ily accessible format including graphs, ta- bles and figures which will appear in their original articles. By placing an emphasis on publishing nov- el and high-quality research papers togeth- er with the latest industry developments related to the Dental Lab, the Dental Lab Tribune section aims to influence the prac- tice of Dentistry on a Dental Lab, research, industry and policy-maker level on inter- national basis. Readers will have direct contact with indus- trial players in a knowledge exchange envi- ronment, creating a forum for discussions, questions and exchange of valuable infor- mation through our ‘feedback session’. For the above targets, I would like to invite all Dental Lab specialists to interact with Dental Lab Tribune. I look forward to ex- changing all related Dental Lab experience with you. Yours faithfully, Rodny .Z. Abdallah Certified Dental Technician By Rodney Abdallah CDT, Lebanon F or the first time dentists and den- tal technicians will be together in one pool of news, business, indus- try, politics and science in the world leading dental newspaper. As a Certified Dental Technician, it is my great pleasure to welcome you to the first Dental Lab Tribune edition within Dental- Tribune Middle East & Africa. I am proud to announce the birth of this Dr. Sami Bseso & CDT. Aiham Farah Damascus/Syria 45 year old female presented to the clinic unsatisfied with the appearance of the composite veneers she had on her upper and lower anterior teeth, besides a phonet- ic problem with the letter S in particular. She desired functional and aesthetic resto- rations. Diagnosis: Intra Oral clinical exam showed discolor- ation, lake of vitality, and poor appearance of the composite veneers on the upper and low- er anterior teeth and the upper premolars, plus a little deep bite in the centric occlusal jaws relation, what prevented from having proportionate dimensions (width to length). Radiographic testing reviled good and bad endo-treatment for different teeth with a questionable over all prognoses. Also it ap- peared to have generalized horizontal bone resorprtion, which played a major role in the loss of the inter-dental papillae. Fig1 Preliminary Clinical Treatment: • Extraction of: 17 • Selective endo-treatment for: 14,15,16,26 • Casted post and core for: 36,37 (cement- ed with Vivaglass glass ionomer cement). • Fiber reinforced composite post and core for: 22,26 (posts were cemented using Vari- olink II and a composite core were built up) RestorativeTreatmentPlan& Implementation Prior to setting up a plan, the dental tech- nician examined the patient’s oral cavity and face carefully at the dentist’s office, an- swered all her questions and developed an idea about her expectations. A collaborat- ed plan by the dentist and technician then was created. Treatment workflow was initiated by tak- ing preliminary impressions. NewVerticalDimension. Taking into consideration that our priori- ties were the reconstruction of aesthetics and its functionality, the dental technician proceeded with a diagnostic wax-up in the new planned vertical dimension of occlu- sion on the upper teeth and 36-37 from the lower teeth (the missing vertical dimension was gained by means of waxing up to the new occlusion level). According to the new vertical dimension, a diagnostic template of silicon (silicon in- dex) was made to the upper and lower teeth to be used as a visual aid, as a prep- aration guide to the dentist, and as a mold for placement of the temporary restorations in the new vertical dimension of occlusion. Determiningrestorative materialsandcorresponding preparationforms To be restored by All-ceramic crowns from IPS Emax Press, maxillary and 36,37 teeth were prepared with the aid of the silicone index. The prepared finishing lines of the abutments had rounded shoulder. Accord- ing to esthetic and biological consider- ations, they were either equigingival or su- pragingival. Fig 3 To be restored by All-ceramic veneers from IPS Emax Press; The Six interior low- er teeth were prepared with the aid of a sil- icone index. The prepared finishing lines of the abutments were chamfer and equigin- gival. Fig 2 Final impressions were taken to the upper and lower teeth with addition silicone (Vir- tual silicone from Ivoclar Vivadent) The shade of the final restorations was cho- Fig 1: Preoperative situation showing the poor appearance of the composite veneers on the upper and lower anterior teeth. Fig 2: Full crown preparation for uppers, with rounded shoulder. Fig 3: Veneers preparation for lowers, with equigingival chamfer. Fig 4: Crowns & veneers (full contour) pressed with (Value 1 ingot) and two coping with (HO1). Fig 5: Internal effects layering by Impulse material from IPS e-max Ceram. Fig 6: The cemented lower veneers showing how internal effects scheme treat light. Fig 7: The cemented upper crowns showing the mamelon effect and the neat contouring of the interdental triangle and the healthy papilla. sen according the patient desire, her skin color and the shade of the natural (not treated) lower posteriors. Direct temporary restorations were made with the aid of the Index, and no signs or symptoms of discomfort were observed or reported over two weeks. LABWORK: Ingot judgment selection I chose the new V1 impulse ingot from IPS e.max press, because the final shade cho- sen A1 was a little extra bright, but be- fore taking the final decision, I had to make sure that the prep color was vital with no discoloration spots on its surface (ND1, ND2) and especially in the lower veneers due to the limited coverage capability, as I learned from my experience that the degree of translucency in Value ingots placed be- tween that of the LT and HT ingots and lit- tle more toward the HT. for interiors; I pressed the V1 as a full ana- tomical structure and proceeded with a cut back technique simultaneously on the en- tire upper crowns and lower veneers. for upper posteriors; I pressed the V1 as a cusp supported design copings And pro- ceeded with the layering technique . except teeth 24-25, and since both abut- ments used here are metal posts, I pressed HO1 (high opacity), then proceeded with the layering technique. (Fig: 4) The internal effects concept. Light absorbing materials are incorporat- ed into the layering scheme to allow light to penetrate into the tooth more rapidly; these materials are usually applied to the incisal third or to the proximal surface of the tooth. Besides their light-absorbing properties, teeth have light-reflecting properties too. Fig 4 Fig 1 Fig 2 Fig 3 Fig 6 Fig 5 Fig 7 8 dENtal lab trIbuNE Dental tribune Middle East & Africa Edition | November 2012