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24 Dental Tribune Middle East & Africa Edition | May-June 2015clinical Clinical case study: esthetic anterior restoration with VITA SUPRINITY By Daniel Carmona Cando, MDT,Spain I nitial situation The case documentation shows a 39 year old patient who presented at Dr. Diego Al- exander Cardenas’ practice in Barcelona, Spain, with two ag- ing metal-ceramic crowns and loss of soft tissue in regions 11 and 21 (Fig. 1). Following comprehensive con- sultation, she opted for a new crown restoration fabricated using VITA SUPRINITY. Crucial in this respect was the unique characteristic of this new mate- rial that combines the esthetic potential of a glass ceramic with the improved strength provided by reinforcement with zirconia. Daniel Carmona Cando A master dental technician from Barcelona, Spain, uses the fol- lowing complex patient case to report on how laboratory users can achieve excellent results with VITA SUPRINITY restorations. This article provides a step-by- step explanation of how VITA SUPRINITY and the VITA VM 11 veneering ceramic can be used to achieve esthetic results in a chal- lenging clinical scenario. About the Author Fig. 1. Initial situation Fig. 5. Following reduction using cut- back technique Fig. 6. Try-in of the crystallized, and as yet unveneered VITA SUPRINITY crowns Fig. 7. Crowns veneered using VITA VM 11 successfully cover the dark stumps Fig.8. Final result Fig. 2. Preparation for the post abut- ment fabricated using VITA ENAMIC Fig. 3. Virtual design of the anterior crowns Fig. 4. Try-in of the milled VITA SU- PRINITY crowns prior to crystalliza- tion Complexity and material se- lection Just how complex this case actu- ally was only became apparent following removal of the inad- equate restorations for prepa- ration: the tooth stumps were strongly discolored and fitted with gold metal abutments. The question needed to be addressed as to whether the planned res- toration could mask this suf- ficiently in order to achieve a satisfactory result from a visual perspective. In the LABORATO- RIO DENTAL FONTCAR labora- tory, we met this challenge by combining the esthetic possibili- ties afforded by VITA SUPRIN- ITY using the cutback technique with the low-melting fine-struc- ture feldspar ceramic VITA VM 11. Milling and reworking The inLab MC XL system (Siro- na Dental GmbH, Wals, Austria) was used for virtual design and milling of the crowns. Following the CAM process, reworking of the new high-performance glass ceramic should only be carried out at low pressure using fine- grained diamond-tipped milling tools as well as special polishing instruments. For cost-effective surface processing that is gen- tle on the material, the techni- cal and clinical versions of the VITA SUPRINITY Polishing Set are recommended. For crystal- lization firing, any vacuum fur- nace that supports slow cooling can be used. The crowns can be placed directly on to honeycomb firing trays with platinum pins, without using firing paste. Final result Despite the unfavorable initial situation, VITA SUPRINITY ena- bled a comparatively good final esthetic result to be achieved in highly efficient fashion, restor- ing the patient’s natural smile. The expectations and hopes of the patient and the entire treat- ment team were met in full. We would like to thank mas- ter dental technician Thomas Gausmann for his enormous lo- cal support!