CAD/CAM - international magazine of digital dentistry

and convexities that vary in complexity and inten- sity from tooth to tooth. The ability to observe and replicate the surface texture and lustre to create an anterior restoration that is indistinguishable from adjacent natural teeth typically requires a highly skilled laboratory technician. However, if one could mimic the surface texture of adjacent natural tooth surfaces and use a milling machine to reproduce it, one could provide a very good aesthetic restoration without the need for a highly skilled laboratory technician. The goal of this article is to describe a novel approach that attempts to reproduce the complexities and nuances observed in the surface texture and lustre of natural teeth utilising the AST technique for CAD/CAM restorations. _Case description The treatment described involved a 43-year-old pa- tient seen at the clinic with the chief complaint of dark staining of his teeth from an- tibiotic therapy (particularly tooth 21; Figs. 1a–d). The pa- tient stated that his appear- ance affected his ability to socialise and smile. The pa- tient expressed an interest in havinghisteethtreatedtoim- prove both his appearance and his occlusion. The clinical investigation showed a very dark root due toendodontictreatment,with compromised remaining co- ronal structure. The endodon- tic treatment was accepted and a fibre post was cement- ed using a dual-cure resin cement (Multilink Automix, Ivoclar Vivadent) according tothemanufacturer’sinstruc- tions, followed by tempori- sation. Tooth 11 also exhibited an abfraction lesion. At this point, it was decided to address the patient’s aesthetic goals with porcelain veneers. To achieve a rapid aesthetic transformation, the treatment plan involved using digital dental tech- nologytogetherwithanovelconceptinwhichcom- posite resin temporary veneers (composite resin shells) were utilised prior to the placement of the final restorations to predict the final aesthetic outcome and to provide lifelike texture. _Materials IPSEmpressCADMulti(leucite-reinforcedglass- ceramic blocks; Ivoclar Vivadent) in shade A2 was selected for the final restorations. No impressions Figs. 2a & b_Image of the Hajto model showing the surface texture of the anterior teeth (a). Image of composite shells under polarised light. Note the opalescence of the composite shells when the photograph was taken under polarised light (b). Figs. 3a–f_Anatomic resin shell being positioned (a), polished (b) and luted (c) without etching and utilising a flowable composite. The texture obtained mimics the original texture of the Hajto model shown in Figure 2 (d–f). I 31 industry report _ anatomic shell technique I CAD/CAM 2_2013 Fig. 3fFig. 3e Fig. 3dFig. 3c Fig. 3bFig. 3a Fig. 2a Fig. 2b