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ePaper created 2015-11-12, 17:51:56 | version 1.38.0
case report _ restorative dentistry I results that look intriguingly similar to the natural dentition can now be easily achieved due to the combination of the ‘enamel-like’ optical properties oftheIPSe.max®CADHTblocks(hightranslucency) and the staining technique—no individual layering is required. Lithium disilicate glass-ceramic blocks (IPS e.max CAD HT C14/A2) were the chosen ma- terial for the case described here. The blanks were processed in the CEREC milling unit (Sirona) using a Step Bur 12 and a Cylinder Pointed Bur 12S (Fig. 9). _Crown seating Aftercrystallisationfiring,therestorationswere fitted on the abutment teeth and their accuracy of fit was evaluated. Minor shape adjustments were performed and the occlusal and proximal contacts adjusted (Fig. 10). Finally, customised effects were applied to the crowns using the staining technique (IPS e.max Ceram Shades) (Fig. 11). The dual-curing luting composite VariolinkR Esthetic DC was se- lected for placing the crowns. This material is availableinseveralshadestoallowanidealesthetic integration. Water-soluble, glycerine-based try-in pastes provide valuable assistance in selecting the correct colour composite (Fig. 12). With these pastes, the shade effect of the all-ceramic resto- ration can be simulated before it is permanently cemented.Thetry-inpastesfeaturethesameshade and translucency as the luting composite after it has been cured. The consistency of the try-in paste is similar to that of the luting composite. In the present case, each time the restoration was tried in with one of the coloured try-in pastes, the shade effect was measured using a colour measurement device(SpectroShade,MHT).Withthefivedifferent shades Light+, Light, Neutral, Warm and Warm+, the translucency can be modified in varying degrees of percentage, ranging from brighter/ whiter to darker/yellower and the darker shades can be used to change between the levels of opac- ityandtranslucency.Withatranslucencyofapprox. 10 per cent and a relatively bright shade effect, the ‘Light’ version was selected for the final ce- mentation. The crowns were seated on the same day (Figs. 13 & 14). _Conclusion In the case presented here, the combination of CAD/CAM technology, a lithium disilicate glass- ceramic and a colour-balanced luting composite enabled us to use a straightforward and efficient method to restore our patient’s smile to its full attractiveness._ Fig. 13_Final seating of the individual crowns. Air blocker (Liquid Strip) was applied to prevent the formation of an inhibition layer during light curing. Fig. 14_Permanently seated restoration. In only one treatment session,thefinalprostheticrestoration was completed and seated. I 29CAD/CAM 4_2015 Dr Carlo Monaco, DDS,MSc,PhD Researcher,Assistant Professor University of Bologna Via S.Vitale 59 40125 Bologna,Italy carlo.monaco2@unibo.it Prof.Dr Giovanni Zucchelli, DDS,PhD Associate Professor Department of Oral Sciences University of Bologna Via S.Vitale 59 40125 Bologna,Italy giovanni.zucchelli@unibo.it Luigi De Stefano,DT Via Martiri D’Ungheria 132 84018 Scafati (SA),Italy info@luigidestefano.com CAD/CAM_contact Fig. 14Fig. 13 CAD0415_26-29_Monaco 06.11.15 12:00 Seite 4 CAD0415_26-29_Monaco 06.11.1512:00 Seite 4