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ePaper created 2016-04-19, 11:51:38 | version 1.38.0
the model (Figs.7–8b). This would provide the technician with a good approximation of the final shape of the pontic. In order to determine the correct location of the contact point, the distance between the bone crest and the gingival crest was measured. Itiswellestablishedintheliter- aturethatapapillawillbepresent if the contact point is no more than 6.5 mm away from the most coronal interproximal height of the bone crest between a natural tooth and a pontic. This can be measured by probing the bone with an endodontic spreader, marking the distance during the ceramictry-inandthenusingitin the fabrication of the restoration. However, using this distance can lead to a very large contact area with a short papilla if the bone is missing. The result is an unnatural, square tooth shape. Hence,thisisimportantinforma- tion for the technician. When ap- plied wisely during ceramic lay- ering, interproximal pink, brown and yellow stains can create a very natural illusion and thus helptoovercomethisproblem.In the course of the treatment in this case, it became clear that the restoration of tooth #13 was un- necessary to achieve the desired outcome. The try-in of the restoration showed that the zeniths of the gingival contours were mis- placed. The use of slide sharing software allowed us to transmit visual information to the dental technicianregardingtheissuesof the desired gingival zenith, inter- proximal stains (to mask the in- terproximal spaces) and the posi- tion of the buccal ridges, which is of paramount importance for the visual perception (Fig.9). Final restorations Even though cementing the ve- neers first has certain advantages (colour stabilisation), in this par- ticularcase,bothtypesofrestora- tions were cemented simultane- ously. The veneer for tooth #22 was pressed from IPS e.max Press lithium disilicate glass-ceramic (LT ingot in Shade A2; Ivoclar Vivadent) and completed with IPS e.max Ceram (Ivoclar Vivadent). Thepressableceramicisavailable in various degrees of opacity and enables aesthetic restorations to be fabricated that blend seam- lessly with the remaining den- tition. Variolink Esthetic LC (in a neutral shade; Ivoclar Vivadent), a light-curing luting composite, was used to cement the laminate veneer (Figs.10–13). The porcelain-fused-to-zirconia bridge (IPS e.max ZirCAD, Ivoclar Vivadent, veneered with IPS e.maxCeram)wascementedwith the self-adhesive, self-curing resin cement SpeedCEM (in the transparent shade; Ivoclar Vivadent) according to the in- structions given by the manu- facturer. Conclusion Smile improvements are very challenging, particularly if har- monisation of the gingival archi- tecture, in addition to restoring the white aesthetics, is required. Only by choosing a multidisci- plinary treatment approach will mutually beneficial communi- cation between the dentist and dental technician take place. This is a prerequisite for achieving success. 19 Dental TribuneAsia Pacific Edition | 1+2/2016 TRENDS&APPLICATIONS Dr Jorge André Cardosoiswork- ing as a dentist in Espinho in Portugal.Hecan be contacted at jorge.andre@ ora.pt. The Dental Tribune International C.E. Magazines www.dental-tribune.com Shipping address City Country Phone Fax Signature Date PayPal | subscriptions@dental-tribune.com Credit Card Credit Card Number Expiration Date Security Code €44/magazine (4 issues/year; incl. shipping and VAT for customers in Germany) and €46/magazine (4 issues/year; incl. shipping for customers outside Germany).** Your subscription will be renewed automatically every year until a written cancellation is sent to Dental Tribune International GmbH, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. 4 issues per year | * 2 issues per year *** €56/magazine (4 issues/year; incl. shipping and VAT) ** Prices for 2 issues/year are €22 and €23 respectively per year. CAD/CAM cone beam cosmetic dentistry* DT Study Club (France)*** gums* implants laser ortho prevention* roots I would like to subscribe to \ SUBSCRIBE NOW! fax: +49 341 48474 173 | e-mail: subscriptions@dental-tribune.com AD Dr Rui Negrão is working as a dentist in Leca da Palmeira in Portugal.Hecan be contacted at rui.a.negrao@ gmail.com. DrTeresaTaveira is working as a dentist in Rio Tinto in Portu- gal. She can be contacted at teresa.taveira@ ora.pt. Oleg Blashkiv is working as a dental techni- cian in Villa Nova de Gaia in Portugal.Hecan be contacted at olegblashkiv@ gmail.com. DTAP0116_18-19_Cardoso 12.02.16 13:04 Seite 2 \ SUBSCRIBE NOW! fax: +4934148474173 | e-mail: subscriptions@dental-tribune.com DTAP0116_18-19_Cardoso 12.02.1613:04 Seite 2