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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
Fig. 2 Fig. 3 Fig. 4a Fig. 4b Fig. 6 Fig. 7a Fig. 7b Fig. 5 Fig. 8 Fig. 9 Fig. 2: SKYN models (according to Dr Jan Hajtó) for the fabrication of the wax-up. Fig. 3: The composite (IPS Empress Direct) is applied into the silicone key. Figs. 4a & b: The composite veneers created with the help of the silicone key show a natural shape and surface texture on the model. Tooth 11 (a). Teeth 15 to 25 (b). Fig. 5: The mock-up is placed in the mouth. The surfaces are being reworked slightly. Fig. 6: Completed mock-up. Photos and videos are used to assess it. Figs. 7a & b: The surfaces of the mock-up are being reworked slightly. Side view (a). Front view (b). Fig. 8: Targeted preparation of the teeth with the mock-up in place. Fig. 9: Close-up of the prepared anterior teeth. Furthermore, the restorations present an accurate copy of the aesthetic wax-up. The different working steps involved in the SKYN concept are demonstrated in the following clinical case. Case report Initial situation The patient visited the practice with a request that mainly concerned aesthetic criteria. She felt that her an- terior restorations looked too yellowish and their shape did not fit in. The restorations had been in her mouth for several years and the patient wanted to change them. First, a series of digital pictures was taken to examine the situation more closely. The patient had a high smile line. However, the fact that her gums were visible when she smiled and her upper lip was asymmetrical did not bother her (Figs. 1a & b). The periodontal apparatus was healthy. The soft tissues did not show any signs of abnormalities either. Treatment planning We recommended the patient to have the anterior re- gion restored with veneers stretching from teeth 15 to 25, and advised her to have the premolars included in the restoration to achieve a harmonious appearance. The patient agreed with our proposal. We drew up the follow- ing treatment plan: – Wax-up using composite veneers to reproduce the natural shape and texture of the teeth. – Mock-up according to the SKYN concept using a light-curing nanohybrid composite (IPS Empress Direct). – Intraoral digital data scan of the mock-up. – Preparation of the teeth with the help of the mock-up. – Digital impression of the preparation using an optical camera. – Fabrication of the temporaries. – Machining of the glass-ceramic veneers (IPS Empress CAD). – Incorporation of the veneers. Fabricating the wax-up The aim of the ceramic veneers was to give more volume to the teeth. The teeth should appear stronger and longer. Adjusting the dental proportions was requisite to creating a harmonious appearance between the teeth and the smile on the patient’s face. To create the wax-up, we used the SKYN models (“Anterior Model Set” by Dr Jan Hajtó) as ref- erence (Fig. 2). This is a reproduction of natural teeth. Upon request by the patient, tooth selection was performed with the help of both the Digital Smile Design programme and the VisagiSMile design and visualisation software. CAD/CAM 1 2018 23