cosmetic dentistry_ beauty & science

20 I I case report _ smile design and reconstruction the occlusion during lateral excursions of the mandible. We had the advantage of postponing the cementation of the crowns until the composite resins had been completely finished, and the in- tegration of colour and specific characteristics of the anatomy had been verified against the natural dentition of the patient, and copied in the crowns, with uniform thickness of 0.5–0.6 mm in the buccal and palatal aspects. We used IPS Empress Direct to restore the lateral incisors and canines in the following sequence: shade A1E on the palatal surfaces, using the rigid silicone pattern obtained from the diagnostic wax- up, shades A2D and A1D in progressive transi- tion, then Trans Opal for the grey halo effect, and shade A1E and Trans Opal for the final layer. At this session, preliminary finishing was performed with the Astrobrush and Politip polishing systems (both Ivoclar Vivadent). Final occlusion was achieved for allrestorations,directandindirect,andfinalphoto- graphs were taken and submitted to the laboratory technician to allow him to replicate the manual polishing and mimic the natural dentition. The crowns were cemented with Multilink N in the Translucent shade (Ivoclar Vivadent) because the teeth were all vital and we did not want to perform an acid etch on the prepared dentine. Multilink N is self-etching and polymerisation occurs upon contact. Thefinalresultwasverynaturallooking:thecus- tomisedbrightandglazingintegratedtheIPSe.max PressrestorationswithIPSEmpressDirectverynat- urally owing to their colour qualities. It was crucial to determine the precise thickness of the translu- cent mass to obtain the final translucent effect of boththeIPSe.maxCeramandthenaturaldentition. _Conclusion Mimicking nature generally involves replicat- ing specific details of the dentition, combining conservative treatments such as teeth whitening with re-establishing a proper occlusal relation- ship, such as anterior occlusal guide, using direct and indirect restorative materials and using the least biologically invasive method possible. Clinical integration of such restorative ma- terials, requiring comprehensive knowledge of them and their systematisation, helps clini- cians achieve homogenous and highly aesthetic results. Theimportanceofdigitaldesignisapreviewof the final result, however, within the possibilities of smile design approach (mathematical and psy- chological), the most important thing is to meet aesthetic expectations of the patient. It is accepted that nowadays aesthetic results depend on the dentist, his or her clinical skills and working technique, and on the experience of the laboratory technician, but achieving aesthetic results is facilitated by suitable dental materials, whose improved optical and mechanical prop- erties match the aesthetic need, and adapting differentworkingprotocolstothevariousclinical situations. The present clinical case exemplifies the op- timum integration of IPS e.max Press, IPS e.max Ceram and IPS Empress Direct, fulfilling the patient’s expectations in a short period._ cosmeticdentistry 2_2013 Prof.Rony Hidalgo Alameda del Crepúsculo #195 Alborada – Lima 33 Peru esteticadentalperu@hotmail.com _contact cosmeticdentistry Fig. 12b Fig. 12a Fig. 13a Fig. 13b