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30 ◊Page 28 CAD/CAM Dental Tribune Middle East & Africa Edition | 3/2017 Fig 11 Fig 12 Fig 13 Fig 14 Fig 15 Fig 16 Fig 17 we can start preparing the teeth using the Acrylic. We prepare our teeth using depth cutter burs and, according to the shade we have chosen, we determine the depth of our preparation and paint over the acrylic guide with a felt tip pen (Fig. 10a, Fig. 10b, Fig. 10c). After that, the Acrylic guide is removed from the tooth surface and the areas that need to be prepared more are clearly seen because of the marked areas that we al- ready painted (Fig. 11). The preparation depth is limited until we take off all of the remaining paint on the tooth. On some occasions, the tooth doesn't have any paint on it. This is because we have cho- sen an additive approach and this means that we only have to prepare a very shal- low chamfer margin and round the sharp corners with a flexible disc to finalise our teeth preparation (figure 12) . This shallow chamfer margin is to ensure a nice fit on the margins and enable a healthy peri- odontal state. The Lab Procedures There are two fabrication options to carry on from here: the ‘conventional way’ or the ‘digital way’. In the conventional way, two impressions are taken from the pa- tient. One impression is of the tooth prep- aration and the other impression is of the impression of the acrylic template on the patient’s teeth. The technician can use this as a guide and build up his veneers using pressable ceramics with external staining or layering techniques. In our case, we continued with the digital Fig 18 way and only used digital impres- sion techniques from the start to the finalisation of the case. We took a digital impression of the tooth prep- aration (Fig. 13) and then we took a digital impression of the patient’s chosen acrylic smile design (Fig. 14). Then, using a digital copying tech- nique, the veneers were designed digitally (Fig. 15). The veneers were then milled, externally stained and glazed (Fig. 16). contacts. Then a full polymerisation is done, after applying a gel on the margins for the oxygen inhibition layer of the composite cement. Then, the margins should be polished with a rubber cup, but never with a dia- mond bur since this will totally ruin the glaze and the polish of the porce- lain on the margins.(Fig. 17) The final results of the cemented veneers are seen from different angles (Fig. 18a, Fig. 18b, Fig 18c). Try In When the veneers are fabricated they should be first tried out in the mouth. The veneers should be tried out one by one in order to check the margins fit accurately, and then together, to see their overall integra- tion with each other, with the lips and finally, with the face. Bonding I prefer a sectional rubber dam placed in the mouth, because it is much easier for the patient and the dentist to isolate the teeth. Once the teeth and the inside of the veneers are surface-treated, they can now be bonded. Preferably, the bonding should start with the centrals, pro- ceeding with the lateral, canine on one side and the other lateral, canine on the other side. The soft tissues should be handled very gently. The easiest way to do that is to place the veneer on the tooth and, once it is completely seated, spot tack it from the middle with a 2mm tip. This will hold the veneer in place intact and then the tip of the light source can be switched to a larger diameter. Light cure the excess flesh around the gin- giva for only 1 or 2 seconds. This will not fully polymerise the luting resin but will bring it to a jelly consistency. That will be very easily cleaned with an explorer or a number 12 blade for the narrow areas. Then, go in between the veneers with a dental floss to cleanse the interproximal The techniques explained above will help to make communication be- tween the patient and the lab more reliable and solid. It will be helpful in achieving the best aesthetic results with minimal tooth reduction. Asst. Prof. Dr. Cag- das Kislaoglu. Studied dentistry at the University of Marmara Den- tal School from 1995-2000. After graduating joined the department of Prosthodontics. He received his PhD in 2005 on the subject of fracture resist- ance and margin adaptation of zirconium bridges. After the year 2000 he started a private practice focusing on Cosmetic Dentistry. His field of attentions are CAD\CAM den- tal treatments and smile design. Since 2009 he is doing several makeover shows on national television focusing on one day smile design makeovers. Since 2013 he is a part time Associate Professor In the Department of Oral Health Sciences and Technologies in Beykent University. Beykent University and Private Clinic Bagdat Caddesi 330-17 Istanbul-Turkey Mobile +905324232700 (also whatsapp) Work +902163028080 info@cagdaskislaoglu.com