Dental Tribune Asia Pacific No. 6, 2016

12 Dental Tribune Asia Pacific Edition | 6/2016 TRENDS & APPLICATIONS #ciosp60years The largest dental event in Latin America! Organizer: International Media: Support: Follow us on: /apcdcentral @apcdcentral /apcdcentral Information: Exhibit Inquiry: Transforming the History of Dentistry AD carefully removed without dam- aging the healthy tooth structure. Next, the teeth were prepared, retraction cords were placed and an impression (Virtual, Ivoclar Vivadent) was taken (Fig. 4). The patient was provided with a tem- porary restoration, which was made with a temporary crown and bridge material (Telio CS C&B, Shade A1; Ivoclar Vivadent) and ce- mented with a dual-curing luting composite (Telio CS Link, Ivoclar Vivadent; Fig. 5). We followed two different routes in fabricating the veneers. We instructed our laboratory tech- nician to make two ceramic ve- neers using the press technique with IPS e.max Press (Shade HT A1, stained; Ivoclar Vivadent), and we milled two ceramic veneers with our in-office CAD/CAM machine using an IPS Empress CAD Multi block (Shade A1; Ivoclar Vivadent) at the same time. The veneers made in the dental office were just polished and not glazed. Figures 6 & 7 allowed us to compare the results from a facial perspective. This experiment illustrated the aesthetic potential of modern ceramics. Both types of restora- tions blended in beautifully with their surroundings. The appear- ance of the veneers produced using CAD/CAM technology came very close to that of the manually man- ufactured version. Nevertheless, in the end, we opted for the laborato- ry-fabricated veneers with the con- sent of the patient, since we were able to achieve a slightly better match to the neighbouring teeth by staining the restorations. Figures 8 & 9 show the try- in pastes (Variolink Esthetic LC, Ivoclar Vivadent) on the prepared teeth. The most suitable composite cement shade was determined on thebasisoftwodifferentlycoloured pastes. With Light+ and Warm+, two extreme options were compared. The difference was clearly visible when the pastes were applied. Even though the darker shade (Warm+) was very close to that of the natural tooth structure and would have worked well with the veneers, we se- lected the lighter shade. This is very common, as in most cases we tend to prefer the lighter version because it provides a better contrast to the tooth structure and therefore ren- ders the removal of excess cement easier and faster. Before the veneers were seated, retraction cords were placed and the enamel was etched (not the dentine; Fig. 10). Adhese Universal (Ivoclar Vivadent) was used as the bonding agent to place the veneers (Fig. 11). The excess luting composite was then carefully removed (Fig. 12) and a glycerine gel (Liquid Strip, Ivoclar Vivadent) was applied. This gel prevents the formation of an oxy- gen inhibition layer at the margins. The luting composite was cured with two curing lights (Bluephase Style, Ivoclar Vivadent) simultane- ously and cooled with plenty of water (Fig. 13). Figure 14 shows the harmonious result produced by the lithium disilicate veneers. Conclusion State-of-the-art restorative ma- terials have immense potential. De- pending on the particular require- ments of the patient and the indica- tion, they allow a suitable treatment option to be determined quickly and easily. The case presented here shows that highly aesthetic ceramic veneers can be fabricated with min- imal effort using in-office equip- ment (IPS Empress CAD Multi). Nev- ertheless, pressed ceramic veneers were chosen for this patient, since they offered the possibility of ap- plying stains, through which a very close match to the neighbouring teeth could be attained. As a prin- ciple, however, highly aesthetic re- sults can be achieved with both approaches if the appropriate treat- ment protocol is followed. Dr Eduardo Mahn is the director of clinical re- search and of the aesthetic dentistry pro- gramme at the Universidad de los Andes in San- tiago in Chile. He can be contacted at emahn@miuandes.cl. 14 Fig. 14: The patient with the new ceramic veneers.

Dental Tribune Asia Pacific No. 6, 2016

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