Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2015-11-12, 17:51:56 | version 1.38.0
I case report _ restorative dentistry veolar bone using simple vertical mattress sutures (PGA 6/0) and anchored to the periosteum on the buccal side. After the surgery, the temporary restorations were inserted using calcium hydroxide cement. This intervention meant that the patient was not able to clean her teeth in the areas af- fected. Instead, she was instructed to rinse with 0.12%chlorhexidinesolutionforoneminute,three times a day. _Temporisation At the following appointment, the sutures were removedandaprecisionimpression—withoutplac- ing a retraction cord—was taken. This impression was used to create a second ‘series’ of temporary restorationsamenabletorelining.Threeweeksafter the surgery, the final preparation of the abutments wasperformed.Thegumlinewasusedasareference to provide orientation in the cervical region. Early temporisation was advantageous to soft-tissue conditioning. With this measure, a potential soft- tissue rebound was easier to monitor and the de- sired aesthetic outcome could be achieved in a tar- getedfashion.Overthefollowingfivetosixmonths, thetemporarieswereadditionallymodifiedtoallow theinterdentalpapillaetogrowintoanappropriate shape. _Intraoral data capturing Six months after the surgery, the soft tissue had developed into an ideal shape (Fig. 5). It was now time to begin with the final prosthetic stage. Only one appointment was planned for this stage. As the patient was satisfied with the morphological shape and function of the temporary restorations, the PMMA restorations were utilised as prototypes for the final crowns. Two digital impressions were required.Atthefirststep,adigitalrecordofthetem- porary restoration was created and subsequently usedasa‘biogeneric’model.Atthesecondstep,the abutment teeth were digitally recorded after a re- traction cord had been placed. Both the temporary restorations and abutment teeth were coated with a dusting of scanning powder to facilitate optical data capturing (Figs. 6–8). After intraoral scanning (CEREC Bluecam, Sirona Dental Systems), the data were imported into the CAD software (CEREC Soft- ware V. 4.2) and integrated into the design of the restorations. The parameters concerning the space for the luting composite and adhesive were set to 30 and 20 μm respectively and the minimum incisal ceramic was set to 1.5 mm. Additionally, digital records of the opposing jaw and bite registration were also taken. _Material All-ceramic restorations should demonstrate naturalopticalpropertiesandofferalifelikesurface texture. Simultaneously with the advancement of CAD/ CAM technology, the manufacture of CAD/CAM blanks has been consistently improved. Aesthetic Fig. 7_The temporary restoration was used as a ‘biogeneric’ model. Fig. 8_Preparing the digital scan of the abutment teeth. Fig. 9_Crowns were designed and then milled from lithium disilicate blocks (IPS e.max CAD HT C14/A2). Fig. 10_Try-in of the milled crowns and adjustment of proximal contacts. Fig. 11_Customisation using the staining technique. Fig. 12_Selecting a suitable shade of the luting composite (Variolink Esthetic DC) using glycerine-based water-soluble try-in pastes. 28 I CAD/CAM 4_2015 Fig. 10 Fig. 11 Fig. 12 Fig. 7 Fig. 8 Fig. 9 CAD0415_26-29_Monaco 06.11.15 12:00 Seite 3 CAD0415_26-29_Monaco 06.11.1512:00 Seite 3