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ePaper created 2015-11-12, 17:51:56 | version 1.38.0
I case report _ restorative dentistry _A platform that allows aesthetic 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. State-of-the-art technologies and materials provide a fast route to achieving excellent results. With careful clinical planning, the chairside part of the treatment can often be completed in a single appointment. Intraoral digital impressioning cir- cumnavigates the risk of deformed impression materialsandallowspreparationstobevisualisedin a3-Dformat.Three-dimensionalvisualisationhelps patients form a clear idea of what their treatment can achieve and increases the likelihood for ob- taining their approval. These advantages are aug- mented by the favourable mechanical properties of modern ceramic materials such as lithium disilicate glass-ceramics (LS2). In a nutshell, the benefits of CAD/CAM-based manufacturing include reduced treatmenttimes,enhancedaccuracyofimpressions andprecisevisualisationofthetreatmentoutcome. Thefollowingcasereportdescribestheclinicalsteps required in the fabrication of anterior single-tooth crowns to achieve functionally and aesthetically first-class results. _Preoperative assessment A female patient presented with anterior metal- ceramic restorations, wishing for an improvement of her aesthetic appearance (Fig. 1). A radiographic examination was carried out followed by an intra- oralphotographicseries.Then,theaestheticparam- eters were evaluated. Using the conceptual treat- ment planning tool Digital Smile Design (DSD, Dr C. Coachman), the desired changes were visualised on the computer and discussed with the patient. Visu- alisation is essential an aesthetically motivated treatment that requires preparation of the tooth structure because it affords the opportunity to fa- miliarise the patient with the most salient changes in a straightforward fashion. Afterthepatienthadapprovedofthetreatment, aconventionalintraoralimpression(polyvinylsilo- xane) was taken and a diagnostic wax-up fabri- cated. 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 restoration. Among other things, the patient’s main concerns were to Fig. 1_Female patient with metal-ceramic restorations, wishing for an improvement of her aesthetic appearance. Fig. 2_Mock-up fabricated on the basis of the wax-up and fitted to the patient’s teeth. Aperfect synergy of technologies CAD/CAM materials in combination with a new luting composite Authors_Dr Carlo Monaco, Prof. Dr Giovanni Zucchelli & Luigi De Stefano, Italy 26 I CAD/CAM 4_2015 Fig. 1 Fig. 2 CAD0415_26-29_Monaco 06.11.15 12:00 Seite 1 CAD0415_26-29_Monaco 06.11.1512:00 Seite 1