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ePaper created 2018-02-16, 11:17:41 | version 1.38.0
maxilla restoration case report | Fig. 3a Fig. 3b Fig. 4 4. seven single crowns on teeth #21–24 and 27, Figs. 3a & b: The master model with as well as in regions #25 and 26. We designed the tooth shape and the occlusal morphology in full anatomical contour in the CAD software. The buccal surfaces should be built up in ceramic in order to achieve optimum aesthetics. In preparation for this, the software performed a cut- back. After the framework design, the individual elements were milled from zirconium dioxide the gingival mask in the articulator. Fig. 4: The upper wax-up in the planned final situation. Figs. 5a & b: CAD construction of the abutments. Fig. 5a Fig. 5b CAD/CAM 4 2017 27 On this foundation, we designed a wax-up with the CAD software (3Shape) and then transferred it to wax. This was the basis for a matrix made from trans- parent silicone, which was sent to the practice. After the dental preparation was complete (implant place- ment, preparation, etc.), the matrix was filled with an auto-polymerising temporary composite (Telio CS C&B, Ivoclar Vivadent) and a temporary restoration was produced and then inserted into the mouth. The temporary restoration served as a dental prosthesis during the implant healing phase, and it allowed us to determine whether the situation, which was planned in the laboratory, harmonised in a functional and aesthetic manner in the patient’s mouth. The patient wore the adapted temporary restoration for approx- imately six months up to the osseointegration of the implants. Production of the final dental restoration Implant abutments The wax-up was positioned on the master model and adapted based on the patient’s and dentist’s feed- back. A double scan followed. We digitised both the model and the wax-up using the laboratory scanner. Subsequently, the implant abutments were produced via CAD/CAM. The implant abutments were milled from a new translucent zirconium dioxide material (IPS e.max ZirCAD, Ivoclar Vivadent). Before sintering, we stained the cervical areas of the frameworks. We used a liquid with a warm yellow tone for the infiltra- tion. After sintering, the implant abutments were adhesively bonded to the titanium bases (TiBase, Straumann) with a luting composite (Multilink Hybrid Abutment, Shade HO, Ivoclar Vivadent) specifically designed for this indication. The self-curing compos- ite provides excellent adhesion qualities. After adhe- sive bonding, the abutments were integrated. Production of the framework The following restorations were planned for the final prosthetic restoration: 1. a bridge in regions #11–13; 2. a bridge in regions #14–16; 3. a crown on tooth #17;