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09 Dental TribuneAsia Pacific Edition | 3/2016 TRENDS&APPLICATIONS The conventional flask technique with a heat-curing denture base material (ProBase Hot, Ivoclar Vivadent) was used to produce the denture. After the polymerisation process,thedenturebasewasground and space was made for building up the Gingiva composite. The surface was conditioned by blasting it with aluminiumoxide(50µm)at200kPa (Fig. 8). A bonding agent was then applied and left to react for three minutesbeforeitwaslightcured. In order to achieve very lifelike resultsinthelayeringofthegingival tissue, saturated (intensive) mate- rials (SR Nexco Paste Intensive Gingiva)wereusedfirst(Fig.9).Next, translucent, light-curing gingival materials (SR Nexco Paste Gingiva and SR Nexco Paste Basic Gingiva) were used to impart the gingival ar- eas with the desired depth (Fig. 10). The colours of the Gingiva compos- ites range from pale pink through reddishandorange to purple.Acer- tain amount of time and effort are necessary to master the necessary mixing techniques and achieve a harmonious interplay of the inten- sive and the translucent materials. Practical experience is essential. With some technical skill, the gingi- val areas can be naturally repro- ducedintermsofshape,textureand shade. Alltheindividuallayerswerepre- cured (Quick curing light, Ivoclar Vivadent) in segments. A high-per- formance curing light was used for the final polymerisation. Prior to this step, a coating of glycerine gel (SR Gel, Ivoclar Vivadent) was applied to the surfaces to prevent oxygeninhibition,whichcouldlead to an unattractive result that is dif- ficult to polish. The surfaces of the teeth were characterised with a ver- tical and horizontal macrostruc- ture. Particular attention was paid to mechanical polishing. Once the glycerine gel had been removed, the restorations were finished with different polishing instruments (various grit sizes, pumice, leather buffing wheels and universal pol- ishing paste; Fig. 11). In the present case, mechanical polishing was pre- ferred to glazing with a light-curing composite in order to prevent pre- matureageingofthesurface. The dentures were seated man- ually with the help of multi-unit abutments from Nobel Biocare (Fig. 12). The screw channels were sealedwithTeflonandlight-curing composite resin. The position of maximum intercuspation was checked and the occlusal path- ways were adjusted to the protru- sive and laterotrusive movements. In addition, the restorations were checked in terms of the ability to clean them with interdental brushes, and the patient was given special instructions regarding her oral hygiene. Conclusion For a long time, ceramics were considered to be the aesthetic benchmark. With the introduction of state-of-the-art industrially fab- ricated acrylic teeth specially de- signedforimplantapplications,the bar for aesthetics has been raised in thiscategoryofmaterials.Theteeth used in this case exhibit a true-to- nature morphology, which allows the restoration to be functionally integrated without any problems. Using the laboratory composite SR Nexco to recreate gingival tissue is an effective restorative approach. Incontrasttoceramicmaterials,the composite resin is easy to handle anddeliversexceptionallyaesthetic results (Fig. 13). The light weight of the material is an added benefit. An all-ceramic restoration (zirconium dioxide framework, layering ce- ramic,gingivalmask)weighsalmost twice as much as a titanium and composite resin denture. Another advantageofthetypeofrestoration describedhereisitslongservicelife. The success of an implant-sup- ported denture depends on the systematic coordination of all the surgical and prosthetic require- ments. A strict procedure needs to be followed from the treatment plan to the final outcome. Layering gingival portions with a laboratory composite represents a genuine improvement on previous materi- als and methods with regard to aesthetics, handling and hygiene (Fig.14). Dr Patrice Mar- gossian main- tains a private practice special- ising in im- plantology und prosthetics in Marseille in France. He can be contacted at pm@patricemargossian.com. Dr Andrieu Pierre is a practising prosthodontist in Aix-en-Provence in France. He can be contacted at andrieupi@ wanadoo.fr. AD DTAP0316_06_09_Margossian 04.03.16 13:22 Seite 2 DTAP0316_06_09_Margossian 04.03.1613:22 Seite 2