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20 Dental Tribune Middle East & Africa Edition | September-October 2015cad/cam > Page 21 *markedtermsareregisteredbrandnamesandtrademarks CopraSintec K perfection in Argon-Sintering-Alloys A perfect synergy of technologies By Carlo Monaco, Italy, Prof. Dr. Giovanni Zucchelli, Italy, Luigi De Stefano, Italy S tate-of-the-art technologies and materials provide a fast route to achieving excel- lent results. With careful clinical planning, the chairside part of the treatment can often be com- pleted in a single appointment. Intraoral digital impressioning circumnavigates the risk of de- formed impression materials and allows preparations to be visualized in a 3D format. Three-dimensional visualiza- tion helps patients form a clear idea of what their treatment can achieve and increases the likelihood for obtaining their approval. These advantages are augmented by the favourable mechanical properties of mod- ern ceramic materials such as lithium disilicate glass-ceramics (LS2). In a nutshell, the benefits of CAD/CAM-based manufac- turing include reduced treat- ment times, enhanced accu- racy of impressions and precise visualization of the treatment outcome. The following case re- port describes the clinical steps required in the fabrication of anterior single-tooth crowns to achieve functionally and estheti- cally first-class results. Preoperative assessment CAD/CAM materials in combination with a new luting composite . A platform that allows esthetic results to be achieved with astonishing ease can be created by combining CAD/CAM technology with a high-strength ceramic and a modern luting material. A female patient presented with anterior metal-ceramic restora- tions, wishing for an improve- ment of her esthetic appearance (Fig. 1). A radiographic exami- nation was carried out followed by an intraoral photographic se- ries. Then, the esthetic param- eters were evaluated. Using the conceptual treatment planning tool Digital Smile Design (DSD, Dr C. Coachman), the desired changes were visualized on the computeranddiscussedwiththe patient. Visualization is essen- tial in an esthetically motivated treatment that requires prepa- ration of the tooth structure be- cause it affords the opportunity to familiarize the patient with the most salient changes in a straightforward fashion. After the patient had approved of the treatment, a conventional intraoral impression (polyvinyl siloxane) was taken and a diag- nostic wax-up fabricated. The gum line was not altered at this stage. The diagnostic wax-up was key in helping the patient fathom the prospective three- dimensional volumetric change in her anterior dentition and fabricating the temporary resto- ration. Among other things, the patient’s main concerns were to have the excessive length of her anterior teeth ameliorated to harmonize with the surround- ing dentition and to have the se- vere palatal curvature mitigated. Planning and temporization The information gained from the DSD procedure and the tryin of the mock-up formed the basis for the final treatment planning. The mock-up model conveyed a precise impression of the mor- phological changes to be ap- plied to the teeth. At the try-in, Fig. 1: Female patient with metal-ceramic restorations, wishing for an improvement of her esthetic appearance. Fig. 3: Suboptimal abutments after removal of the existing restorations Fig. 2: Mock-up fabricated on the basis of the wax-up and fitted to the patient‘s teeth. Fig. 4: Abutments after having been built up with compos- ite. Situation at the end of the first temporization step Fig. 5: Second temporary stage after surgical crown lengthening