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CAD/CAM - international magazine of digital dentistry - wydanie polskie

38 1_2014 CAD/CAM 38 case report _ CAD/CAM in implantology 18 I I case report _ CAD/CAM in implantology substructure.Nosystemcanapplyporcelaininsuch awaythattherestorationlookslikeanaturaltooth. Hence, the ideal is to combine the possibilities of- fered by CAD/CAM with the artistic abilities of the dental technician. A properly prepared construc- tion, good marginal seal and the choice of material are all very important factors, but the final finish of the crown still depends on the aesthetics attained through the skill of human hands. The work of the dental technician requires knowledge of many dif- ferentmaterialsandhowtheyarefashioned,aswell as extensive manual skills in working easily with both colour and shape. A long-standing acquaintance of mine, the out- standing master of dental technology Klaus Müter- thies, stresses repeatedly that form takes prece- dence over colour. The patient focuses first on the way the prosthetic restoration harmonises with his naturalteeth.Iftheformisdisturbed,colourdefects appear together with details that do not have too important an influence on the overall appearance of the crown. Although the majority of patients do not know how to assess a prosthetic restoration accurately, I have noticed a growing awareness among them of the quality of the work. This is increasing in pro- portion to general advances in people’s lifestyles. The majority of us want to remain young and look beautiful forever. Hence, more and more people view dentition in terms of the need not only to re- store missing teeth but also to correct those they still have. A good example of this is the boom in or- thodontics, and the demand for teeth whitening and improving their smile using veneers. Another very important factor in prosthetic art is that it requires the collective effort of an entire team—everyone from an attending dentist, an or- thodontist, and a surgeon/implantologist, right up to a dental technician. I have had the great fortune to work with partners who have chosen to work in the same area of technological development and aestheticprostheticwork.Oneofthedoctorswork- ingcloselywithmylaboratoryonadailybasisoften remarks, “as the dentist so the technician and vice versa”. Probably, these words reveal how close the ties have always been between the dental techni- cianandthedentist.TherestorationcasestudyIwill present here reflects my belief that prosthetic work is a combination of modern technology with its skilfuluseandahighlevelofartistryinthehandsof the technician. _Case report A 27-year-old female patient presented to our dental office to achieve a more aesthetic smile. At theageof17,shehadsufferedanaccident(shewas hit by a swing), as a result of which her tooth #21 had shifted significantly in an upwards direction owing to significant bone atrophy and root resorp- tion(Fig.1).Theyoungageofthepatientandherstill progressing bone growth did not augur success. Only when she was 27 did she pursue improving herappearance.Thesituationrequiredthatshehave her tooth extracted, undergo an implant procedure and have a prosthetic crown placed. The first prob- lem that emerged during the preliminary analysis priortotheimplantprocedurewasthattheamount of bone and the thickness of the bone plate would Fig. 12a_All-zirconia abutment on the cast. Fig. 12b_Palatal view of all-zirconia abutment. Fig. 12c_Preparation of the abutment. Fig. 12d_Prepared abutment. Figs. 13a, b & c_Finished zirconium dioxide substructure on the cast. Buccal view (b). Palatal view (c). Fig. 14_Fitting of abutment and coping. Fig. 15_Diffusion of light in Robocam zirconia structure. CAD/CAM 2_2012 Fig. 12c Fig. 12d Fig. 12a Fig. 12b Fig. 13a Fig. 13b Fig. 13c Fig. 14 Fig. 15