Please activate JavaScript!
Please install Adobe Flash Player, click here for download

Cosmetic dentistry_beauty & science

dentistry 3_2014 cosmetic28 phosphoric acid for 45 seconds. They were then rinsed with water for the same period. Subse- quently, Variolink Veneer light-curing adhesive composite was applied. Meanwhile, the inner surfaces of the vene- ers were etched with 7% hydrofluoric acid for 1 minute, rinsed with water and then the veneers were placed in the ultrasonic bath for 2 minutes. Silane (Monobond Plus, Ivoclar Vivadent) was applied to the etched surface of the veneers, which were then dried, and the bonding agent (Heliobond, Ivoclar Vivadent) was applied. Vario link Veneer in shade HV+1 was applied to the ve- neers’ surface and the veneers were placed on the abutments. Excess material was initially removed and precured for 10 seconds. The restoration ed- ges were smeared with glycerine gel to prevent oxygen access and the formation of an oxygen inhibition layer on the composite bond. Curing was continued with an 800 mW/cm2 polyme- risation lamp for 60 seconds on each surface. Excess composite was removed with a #12 scal- pel blade, and the veneers were polished with strips and rubber polishing burs for composites. Finally, the veneers were checked during occlu- sion and articulation using 14 µm articulating paper. Corrections were made using a 45 µm smooth diamond-coated bur on a 1:5 speed- increasing handpiece on a micromotor. The final polishing was performed using rubber burs for composites (Figs. 11a, b). After a week, gingival integration with the veneers had been achieved (Figs. 12a, 12b, 13 a-d). After a period of healing, the emergence profile of the implant restorations was reshaped using crowns on temporary abutments (Figs. 14a, b). After obtaining a satisfactory effect for im- plants 24, 35 and 45, permanent zirconia crowns on standard zirconia abutments were fabricated (Figs. 14c, 14d, 15a-c, 16a, 16b). Owing to the thick layer of soft tissue, a mo- dified screw-retained zirconia crown on a zirco- nia abutment was placed on implant 14 (Figs. 17a, b). The emergence profile was reshaped using a crown bonded to the standard zirconia abutment and the crown was veneered with feldspathic ce- ramics only at the supragingival zone, owing to the unavailability of individually shaped zirconia abutments for the OSSTEM system (Fig. 18). _Conclusion Working with patients missing so many permanent teeth is extremely difficult and so- metimes marked with compromise. Achieving a satisfactory result both functionally and ae- sthetically is possible only through the close co-operation of specialists from various fields of dentistry and meticulous planning from the commencement of treatment to the final aesthe- tic stage (Figs. 19a, b, 20). As I mentioned at the beginning, apart from other crucial issues, it is important to preserve the patient’s own tissue as far as possible, which translates into the longevity and stability of the restorations. The case presented demonstrates that. We achieved satisfactory long-term aes- thetic and functional results with minimum in- tervention. After two years, there is perfect bone stabi- lity around the implants (Figs. 21a-d) and excel- lent gingival integration with the prostheses on both the implants and the natural teeth (Figs. 22a, 22b, 23a-d, 24). Dr Magdalena Jaszczak-Małkowska (DMD) graduated from the Medical University of Warsaw in Poland in 1996. Until 1998, she was a collaborator with the Institute of Genetics and Animal Breeding of the Polish Academy of Sciences. In 2008, she obtained a certificate in Prosthodontics. She has worked in a private practice specialising in aesthetic and prosthodontic dentistry since 2000. ESTEDENTICA ul. Dobra 27/A, 00-344 Warsaw, Poland m.jaszczak@estedentica.pl Dr Joanna Witanowska (DMD) graduated from the Medical University of Warsaw. She is a specialist in orthodontics and a research fellow at the Department of Orthodontics at the University. She is completing a doctoral thesis in Orthodontics. ul. Nowogrodzka 59, 02-005 Warsaw, Poland jwitanowska@gmail.com Dr Małgorzata Zadurska (DMD, PhD) graduated from the Poznan University of Medical Sciences in Poland. She is a specialist in orthodontics and paediatric dentistry, and Associate Professor at and head of the Department of Orthodontics at the Medical University of Warsaw. Nowogrodzka 59, 02-005 Warsaw, Poland _about the authors Fig. 24_Pantomographic X-ray two years after implants loading, perfect bone stability. Fig. 24 case report _ biomimetic approach

Sito