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ePaper created 2014-10-09, 17:54:05 | version 1.30.01
25dentistry 3_2014 cosmetic to evaluate the aesthetics and to establish the implant-prosthodontic rehabilitation necessa- ry. Photographs were taken at different angles and diagnostic casts were mounted in an Artex partially adjustable articulator (AmannGirrbach) using the facebow registration and the centric relation registration techniques by Dawson. _Analysis of occlusion and articulation Normal occlusion was present, and incisal and canine guidance was restored (disclusion of posterior teeth during protrusion and latero- trusion). Normal occlusal contacts and intercu- spation were present. In centric relation, no pre- mature contacts and traumatic occlusion were seen in articulation (centric relation = maximum intercuspation). No subjective or objective temporomandibu- lar joint problems were registered. Spaces were closed and tooth contacts were restored in the maxillary and mandibular anterior segments. The space necessary to restore missing teeth 24, 25 and 45 was established by orthodontic tre- atment. In order to restore missing tooth 14, the space was maintained by retaining the persistent primary molar (Figs. 5a-d). _White and red aesthetics About 1 mm of the incisal edges was visible with lips in the rest position. During smiling, nor- mal exposure of the maxillary teeth was present and the incisal line did not follow the curvature of the lower lip. In order to maintain the canine guidance, elongation of the maxillary incisors was not possible. The anterior gingival margin line was normal. _Treatment plan re-evaluation In order to establish the treatment plan and to analyse aesthetics in the anterior segment, the diagnostic wax-up and mock-up were crea- ted, which enable an assessment of the propor- tions and appearance of the final restoration in the patient’s mouth (Figs. 6 a, b). It was decided to recontour the mesial angles of the maxillary central incisors with composite and to apply two ceramic feldspathic veneers sin- tered on a refractory mass to the lateral incisors. Figs. 13a-d_The maxillary lateral incisors without and with veneers, showing perfect white and red aesthetics. Figs. 14a-d_Gingival shaping with the healing screw and temporary crown (a & b), zirconia abutment and final restoration (c, d). Figs. 15a-c_Teeth contacts after prosthodontic treatment. Fig. 13a Fig. 14a Fig. 15a Fig. 15b Fig. 15c Fig. 13c Fig. 14c Fig. 13b Fig. 14b Fig. 13d Fig. 14d case report _ biomimetic approach