Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2018-02-22, 09:57:51 | version 1.38.0
PUBLISHED IN DUBAI www.dental-tribune.me September-October 2017 | No. 5, Vol. 7 Many ways with one material By Dan Krammer, Germany At this unusual event, twenty par- ticipants were asked to treat a real patient by using three different treatment approaches. At the end of the session, the patient had to decide which type of restoration she pre- ferred: the IPS e.max® CAD restora- tion made with a chairside method and completed by the dentist; a conventional CAD/CAM-fabricated restoration; or a restoration made of IPS e.max Press. The attending den- tist and representative of the chair- side approach, Dr Petr Hajný looked like he was going to break out into a sweat once he fully understood the implications of this challenge. The contenders were not to be underesti- mated. His preliminary work and the needs of his patient would set the standard for his fellow contestants (Figs 2 to 3g). In actual fact, the task turned out to be more complex than was initially anticipated. A wide array of fabrication options was available. The participants were able to choose between IPS e.max CAD (lithium dis- ilicate); highly translucent IPS e.max ZirCAD (zirconium oxide) either in monolithic or anatomically reduced form, ground or milled; or IPS e.max Press full-contour or anatomically reduced pressed and subsequently stained/veneered restorations; or a combination of all these versions. The choice was extremely wide be- cause of the exceptional versatility of the all-ceramic product portfolio of Ivoclar Vivadent (Fig. 4). For those of you who fi nd your head spinning at the thought of all these possibili- ties, you will be relieved to know that the solution actually turned out to be quite simple. This contest offered a number of possibilities for comparing different methods, such as the CAD/CAM and the conventional fabrication tech- niques, and analyzing them accord- ing to a number of critical aspects. Nevertheless, the patient would be the deciding factor in this challenge. She would be the one who would make the fi nal decision, irrespective of whether the restoration was fabri- cated chairside, stained, veneered or fabricated with the conventional or CAD/CAM technique. Which group would get the job done fi rst? The conventional or the CAD/ CAM representatives? The dental technicians or the dentist? And at what esthetic price? All these issues would be addressed and the debates over many different matters resolved. Could the simplest restoration perhaps be the most at- tractive one? How important is the number of powders and colours that are used? What is the signifi cance of the shape and surface structure of the restoration for the overall es- thetics? How important are listening skills to fi nd out what the patient re- ally wants? In any case, the event offered the par- ticipants a wonderful opportunity to fi nd out all the answers to these questions and more from the most important person in this case: that is, the patient. Now, let’s join the contestants at the ICDE in Vienna (Fig. 5) and accom- pany them on this exciting journey… (Figs 6 to 41). ÿPage B2 Dan Krammer teamwork media GmbH Hauptstrasse 1 | 86925 Fuchstal | Germany d.krammer@teamwork-media.de Fig. 1: Before the case is presented, Hannes Meischl, Technical Trainer of the ICDE in Vienna, describes the dental laboratory pro- cedure and the available materials and equipment. Fig. 2: Dr Petr Hajný, a dentist and dental technician who hails from the Czech Republic, describes the case and its challenges. The task is to restore the patient’s teeth 13 to 23 with all-ceramic crowns. Recently, nineteen dental technicians from all over the world and one dentist from the Czech Republic convened at the International Center of Dental Edu- cation (ICDE) in Vienna. They were invited by Ivoclar Vivadent to take part in a very special educational session, where they were given the opportunity to compare their expertise with other seasoned dental professionals. The title of the challenge was “One aim, three solutions”; the material they would be using was IPS e.max. LIFELIKE ESTHETICS – EFFICIENTLY PRESSED IPS e.max® PRESS MULTI THE WORLD’S FIRST POLYCHROMATIC PRESS INGOT • Monolithic LS2 restorations showing a lifelike shade progression • Exceptional combination of strength, esthetics and effi ciency • For crowns, veneers and hybrid abutment crowns • Coordinated with high-precision Programat press furnaces • Maximum cost effectiveness in the press technique c e r a m i c y o u n e e d l l a l a l Fig. 3a-3g: Dr Hajný shows photos of the preoperative situation. He highlights the esthetic failings of the old restorations in the central incisors. In order to enhance the esthetic appearance of the new restoration, the patient agrees to have tooth 12 and 13 and tooth 22 and 23 included in the restorative treatment strategy. The three groups – conventional laboratory, CAD/ CAM laboratory and CAD/ CAM chairside – are allocated a specifi c time in which to fabricate the all-ceramic restorations for teeth 13 to 23. The old crowns are removed from tooth 11 and 21. Tooth 11 is shown to have been restored with a metal root post in the past. Dr Hajný masks the post with opaquer to adjust the shade. www.ivoclarvivadent.com Ivoclar Vivadent AG Bendererstrasse 2 | 9494 Schaan | Liechtenstein Tel.: +423 235 35 35 | Fax: +423 235 33 60