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ePaper created 2016-03-29, 15:23:51 | version 1.38.0
Fig. 1: Unattractive, old porcelain- fused-to-metal restorations on teeth #11 and 21 in a 20-year-old patient. Fig. 2: Close-up photograph of the functionally intact anterior crowns showing unattractive PFM work due to the metal framework showing through. Fig. 3: Incisal view of the existing crowns. Fig. 4: The self-conditioning ceramic primer Monobond Etch & Prime is scrubbed in for 20 seconds. Fig. 5: Additional reaction time of Monobond Etch & Prime of 40 seconds. Fig. 6: Apical view of the IPS e.max Press lithium disilicate crown after Monobond Etch & Prime had been rinsed off. Anteriorcrownscomeinmanydifferentvariations, from purely functional to highly aesthetic, depend- ing on the requirements and means of the patient, the skill of the dental technician, availability of materials, and preparation and cementation pro- cedures used. Many anterior crowns considered to beaestheticinthepastnolongermeetthedemands of today’s patients. The example detailed in this article is a case in point. Whenshepresentedtoourpractice,the20-year- oldhighschoolgraduatewishedtohavethecrowns on her two central incisors replaced (Fig. 1). At the age of 14, she had sustained anterior tooth trauma that apparently damaged the mesio-incisal part of the incisal edges of both teeth. The dentist she had consulted at that time restored her teeth with por- celain-fused-to-metal (PFM) crowns. Even though the extent of the trauma can no longer be assessed, today’s alternative—in light of the patient’s young age in particular—would most probably have been a direct composite restoration. Figure 2 shows the two central incisors in detail from the labial aspect and Figure 3 shows an incisal view. The crowns did not exhibit any functional defects. As a result, the main treatment aim was to improve the aesthetic appearance of the anterior teeth as requested. Subsequently, the patient was informed about the treatment procedure, in par- ticular about any possible additional preparation requiring the removal of tooth structure, as well as the cost involved. The treatment was begun at a separate appoint- ment.Therestorationswerefabricatedbythedental | trends & applications luting protocol 06 cosmetic dentistry 1 2016 An innovative adhesive luting protocol All-ceramic anterior crowns (IPS e.max Press lithium disilicate) placed with Monobond Etch & Prime Author: Prof. Claus-Peter Ernst, Germany Fig. 4 Fig. 5 Fig. 6 Fig. 1 Fig. 2 Fig. 3 dentistry 12016