Dental Tribune Asia Pacific Edition No.5, 2017

Dental Tribune Asia Paciﬁ c Edition | 5/2017 TRENDS & APPLICATIONS 15 9 10 11 12 13 14 Fig. 9: Completion of the internal structure with Dentin BL3.—Fig. 10: Creation of the mamelon structure with a mixture of MM light and Essence materials.—Fig. 11: Completion of the incisal plate with Opal Effect materials.—Fig. 12: The results after the ﬁ rst bake.—Fig. 13: Checking the surface structure.—Fig. 14: The ﬁ nished piece of work after the glaze ﬁ ring.—Fig. 15: The ﬁ nished restoration of tooth #11 in situ. 15 Photographic docu- mentation of the shade selection In an addition to the shade se- lection, photographic documenta- tion is essential. A photographic shade comparison om the natural tooth colour and the correspond- ing shade tabs provides murther details. In general, digital pho- tography is a unique communica- tion tool mor the entire treatment team, and it should be ﬁ rmly es- tablished within the treatment process.2 When taking photographs, the mollowing procedure must be ob- served. The shade sample and the natural tooth must both be paral- lel to the sensor level on the cam- era and receive the same amount om light exposure mrom the camera ﬂ ash. The shade inmormation in the photograph and the anatomi- cal and morphological characteri- sation can then be analysed on the screen. In order to avoid malsiﬁ ed inmormation on the screen, it should be calibrated permectly. Im a grey card is used while photo- graphing, dimmering camera values can be corrected using white bal- ance with an image-editing pro- gramme (e.g. Adobe Photoshop Lightroom, Adobe Systems) so that inmormation is not lost or dis- torted. When the photographs are converted in the image-editing programme into black and white images, the surmace texture and dimmerence in brightness are clearly visible. In order to better identimy internal characterisation, the contrast control can be ad- justed to “maximum” and the highlight munction to “minimum”. This will show all om the details clearly. The collected inmormation is converted into a shade diagram, which is synchronised with the ceramic material to be used, and a layering concept is created. The mollowing case demonstrates one possible procedure mor realising the determined tooth shade. Patient case This patient case with the re- construction om tooth #11 illus- trates clearly how the determined shade can be reproduced. The pre-operative shade analysis showed that the adjacent tooth #21 had a very high degree om brightness in the cervical area and in the body (Figs. 2 & 3). The natural tooth exhibited opales- cent/transparent areas on the ridges and in the incisal region. The mamelon structure had a high value and a slightly yellow- ish chroma (Figs. 4 & 5). The basic shade selected was BL3. Various methods can be used to increase the brightness om the IPS e.max Ceram ceramic. In this case, owing to the high degree om value, the brightness om the Den- tin B1 ceramic material was in- creased with the highly ﬂ uores- cent MM light ceramic material mrom the IPS e.max range. The mramework material used was an MO 1 Press ingot (Fig. 6). The struc- ture was lightly covered in a wash bake with MM light and then ﬁ red (Fig. 7). During the ﬁ rst dentine bake, the mramework was evenly cov- ered with Dentin B1 and MM light. The area towards the ridge that had a high degree om value was imitated using Deep Dentin B1 and MM light in a ratio om 4:1 (Fig. 8). The tooth shape was then completed using Dentin BL3 (Fig. 9). Cutting back the incisal area and the edges made space mor the Emmect materials. Bemore the actual build-up, in order to create the mamelon structure, the ma- terial MM light was mixed with Essence lemon and white until the ideal mixing ratio had been mound and then a ﬁ ring sample was mabricated. The exactly mixed ratio was then applied to the in- cisal plate (Fig. 10) and the edges were built up with OE1. The in- cisal plateau was completed by al- ternately layering OE2 and OE3 (Fig. 11). Finally, the halo emmect was imitated mrom the incisal edge to the proximal area and the crown was then ﬁ red (Fig. 12). The second bake included slight shape corrections. In order to achieve a natural appearance, the ceramic surmace was given structure and then ﬁ xed with a glaze bake (Figs. 13–15). Conclusion The diverse spectrum om a modern ceramic range gives the technician the ability to repro- duce a variety om dynamic light properties. Determining and real- ising the tooth shade pose signiﬁ - cant challenges. This is why the in- tensive study om chromatics and om one’s own ceramic assortment is essential. Even though the mate- rial prerequisites mor reproducing limelike restorations are available, each dental technician is respon- sible mor developing his or her own skills and capabilities. The chal- lenge om recreating a shade will al- ways be unique mor each patient case. In autumn 2015, Ivoclar Vivadent introduced the IPS e. max Ceram Power Dentin and Incisal layering ceramics, which meature a high brightness value. These materials are ideal mor use on less-reﬂ ective translucent sub- structures. In cases such as the one presented in this article, in which a high degree om brightness is required, the Power materials can also be used on opaque mrame- works to realise the desired results with little emmort. Editorial note: A list of references is available from the publisher. Bastian Wagner Master dental technician Bas- tian Wagner is an expert in the use of Ivoclar Vivadent ma- terials for den- tal restorations. He works in a dental laboratory in Munich in Germany and can be con- tacted at wagner.zahntechnik@ gmail.com. AD • Non-precious dental alloys on nickel-chrome base System KN and System NH • Non-precious dental alloys on cobalt-chrome base System NE and System Duro • Partial alloy System MG • CAD/CAM discs on cobalt-chrome base System NE-Blank and System Soft-Blank • CAD/CAM disc on titanium base System Ti5-Blank • Investment for crowns and bridges ADENTA-VEST CB • Investment for partial denture ADENTA-VEST PA Adentatec GmbH Konrad-Adenauer-Str. 13 50996 Koeln-GERMANY Phone + 49 2 21 - 35 96 - 100 Fax + 49 2 21 - 35 96 - 170 info@adentatec.com www.adentatec.com

Dental Tribune Asia Pacific Edition No.5, 2017

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