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ePaper created 2015-09-09, 12:07:54 | version 1.38.0
case report _ implant restorations I in a thin layer of wax to create the space neces- sary for the cement that would later be used. The tertiary structure was invested, cast in a cobalt– chromium alloy using induction casting technology and then finished. The tertiary structure was intra- orally cemented on to the electroformed telescopes (Multilink Hybrid Abutment and Monobond, Ivoclar Vivadent) in order to obtain a tension-free restora- tion (Fig. 11). _Aesthetic design The structure obtained was covered in an opaque light-curing laboratory composite (SR Nexco, Ivoclar Vivadent) in pink and white prior to finishing the prosthesis.Again,thesiliconekeywasusedasaguide. The SR Phonares II teeth were repositioned from the wax set-up to the framework. The occlusal parame- ters were checked again and then we proceeded to complete the restoration. In order to reconstruct the pink gingival portion, we used the IvoBase Injector system (Ivoclar Vivadent). First, the denture was in- vested in two specially designed flask halves using Type III and IV plaster. After removing the wax and isolatingtheplastersurfaces,wepreparedanIvoBase capsule and placed it together with the flask into the polymerisation chamber. The IvoBase injection and polymerisation process is fully automated and takes about 60 minutes. Users can choose between two programme options. Running the standard programme takes about 40 minutes. If the RMR pro- gramme is additionally activated, the pressing time increases, as a result of which the monomer concen- trationisreducedtolessthanonepercent.Thisaspect is beneficial to patients because the risk of allergies and irritation of the mucous membrane is virtually eliminated. After the injection programme was complete, the flask halves were opened, and the denture di- vestedfromthestonecoreandprocessedwithmilling and polishing instruments. In order to create a tooth replacement that closely met the expectations of the patient, we decided to customise the visible areas of the denture by applying additional material (SR Nexco). To this end, the vestibular surfaces of the anterior teeth and the corresponding pink parts weresand-blasted.SRConnect(IvoclarVivadent)was applied and the teeth and prosthetic gingiva were characterisedwithSRNexco.Theshapewasadjusted in accordance with the requirements of the patient. Final polishing was carried out with biaxial brushes and pads. The result proved very lifelike (Figs. 12–15). _Conclusion Manypatientsarereluctanttobegivenremovable dentures. If dentures are optimised by adding the stability of implants and the effectiveness of tele- scopes, dental professionals will be able to help patients overcome their reservations and offer them a tooth replacement that provides the level of com- fort they expect. Completely edentulous patients havethesamehighaestheticexpectationsaspatients requiring fixed restorations. However, some of these requirementsaremoredifficulttosatisfyintheeden- tulouspatient,becausewehavetoreplacesofttissue in addition to missing teeth. In order to achieve this, weneedtofindawaytocreateharmonybetweenthe pink and white aspects of the denture. Today’s patients tend to be well-informed. They have ever higher expectations of the aesthetic and functional aspects of tooth replacements. Therefore, we need to be well trained and know which materials and technologies can aid our work and increase our efficiency.Thiswillenableustosolveanyclinicalcase, regardless of its difficulty._ Fig. 14_The macro-texture and shade effect of the denture were individualised in a straight forward manner to achieve a result that is true to life. Fig. 15_The implant-retained overdenture in the patient’s mouth. I 25CAD/CAM 3_2015 Cristian Petri is working as a dental technician at Artchrys Dental Laboratory in Cluj-Napoca,Romania. He can be contacted at office@artchrys.ro. CAD/CAM_contact Fig. 15Fig. 14