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ePaper created 2015-09-09, 12:07:54 | version 1.38.0
I industry report _ composite restorations _To date, no material has been able to imi- tate natural teeth precisely. However, in the course of the CAD/CAM revolution, we are mov- ing one step closer to this target. The restorations presented in this article emulate the physics of the natural tooth through a material system with a buffer effect. _Case report A 48-year-old patient was no longer satisfied with his telescopic restoration in the maxillae. This involved a framework with veneers from tooth #14–24. Removing it in the evening was difficult. Furthermore, there were gaps visible in his dentition at regions #15, 35 and 45, and these were making him increasingly unhappy. He had finally decided to call his dentist’s office with the request for implants and correction of his old restoration. The clinical findings showed that periodontitis had developed owing to the old restorationsittingbadlyandthedifficulthygiene. This was initially treated and brought to a halt before further measures were begun. The tele- scopic bridge was readjusted so that the pa- tient could continue to use it. The mandible showedabrasionsandoverlappingoftheanterior teeth,whichwastoremainuntreatedforthetime being. _Therapy decision after patient briefing and consultation After the periodontitis had healed and in- structioninpersonaloralhygienehadbeengiven, implants were recommended to the patient dur- ing a consultation. Such a restoration would pre- vent tooth migration, stabilise the current situa- tion, and ensure a permanent fit of the present maxillary restoration. The bone available for the implantswassufficientinregions#15,35and45. This condition could alter with time and could both complicate and raise the cost of a future implantation necessitating augmentation meas- Fig. 1_Maxillary plaster model with implant analogue. Fig.2_Plastermodelwithgingivalmask. Fig. 3_The scanning procedure. Figs. 4a & b_Saw-cut region #15 in the scanner (a). Saw-cut regions #35 and 45 in the scanner (b). Figs. 5–7_For the reconstruction and terminal occlusion concept, tooth #15 was considered as tooth #16, and tooth #35 as tooth #36. Fig. 8_Software suggestions for modelling the three abutments. Asystem like natural teeth: Elastic inside, harder outside Author_ Dr Christian Jerecinski, Reinhild Schmidt & Manuela Bandl, Germany 42 I CAD/CAM 3_2015 Fig. 1 Fig. 2 Fig. 3