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ePaper created 2018-02-22, 09:57:51 | version 1.38.0
26 ◊Page 24 RESTORATIVE Dental Tribune Middle East & Africa Edition | 5/2017 Dental Tribune Middle East & Africa Edition | 5/2017 Fig. 13: Adhesive cementation of the ce- ramic veneers with a rubber dam in place Fig. 14: Close-up of the veneers after seating Fig. 15: Texture and tooth shape look Fig. 15: Texture and tooth shape look natural and harmonize with each natural and harmonize with each other. Creating the fi nal restoration For the CAD construction, the two data sets (temporaries, prepared teeth) were superimposed in the software (Fig. 10). Subsequently, the shape of the temporaries was matched to the preparation margins. Each component was examined (preparation margin, thickness, con- tact points, etc.) separately before the data was transmitted to the milling unit for machining (Fig. 11). For the fabrication of the veneers, we decid- ed to use the IPS Empress CAD Multi blocks, which feature a lifelike shade transition from the dentin to the in- cisal. We selected a block in shade A1. Each veneer was positioned in the block in such a way that the trans- lucency of the incisal area matched our requirement. Once the veneers were milled, we checked their fi t on Fig. 16: Lip appearance and portray picture (below) with Fig. 16: Lip appearance and portray picture (below) with the completed restorations. The expectations of the pa- the completed restorations. The expectations of the pa- tient have been met. the prepared dies of the model and assessed their contact points with each other. The surface texture was lightly reworked (Fig. 12). To achieve a highly esthetic result, we additionally characterized the veneers with Stains and Essence materials (IPS Ivocolor®) before we glaze-fi red them (Fig. 11). Seating the ceramic veneers At the try-in, the shade and fi t were checked. All ten veneers showed an excellent fi t in the mouth. The next step was adhesive bonding. Prior to the bonding procedure, a rubber dam was placed to isolate the treat- ment fi eld and keep it dry. As the natural teeth were not discoloured, we were able to use a translucent lut- ing composite (Variolink® Esthetic) to insert the veneers (Fig. 13). The veneers were seated using the following protocol: • The restorations were etched with hydrofl uoric acid for 60 sec- onds, rinsed under running water and dried with compressed air. • The veneers were then condi- tioned with silane. A universal primer (Monobond® Plus) was applied, allowed to react for 60 seconds and dried. • The prepared teeth were etched with 37% phosphoric acid gel (Total Etch) and rinsed. • Fluoride-releasing Excite®F DSC adhesive was applied (without light- curing). • The veneers, which were coated with luting composite, were seated. • The luting composite was tack- cured for 1 to 2 seconds (Bluephase with Polywave LED) to facilitate the clean-up of excess luting composite. • Final light curing of all veneers for 40 seconds • Removal of the rubber dam and occlusal check. At the last step, the restorations were polished. The ceramic restorations show an appealing esthetic appearance in the mouth and harmonize beautifully with the smile of the young patient. The planned situation was accurately transferred to the fi nal restoration (Figs 14 to 16). Conclusion Modern materials in esthetic den- tistry allow pleasing results to be achieved with considerably more ease than before. It may be consid- ered a substantial progress that the resulting restorations meet not only high esthetic requirements but also essential functional criteria. State-of- the-art planning tools, digital auxilia- ries, CAD/CAM-supported manufac- turing and promising materials lead to excellent results and ensure high patient satisfaction. However, never mind the CAD/CAM technologies, the skills and experience of a sea- soned dental technician will remain indispensable.