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B4 ◊Page B3 LAB TRIBUNE Dental Tribune Middle East & Africa Edition | 2/2018 Fig. 11: Conditioning of tooth 11 for the adhesive cementation procedure Fig. 12: Situation after seating the veneers on teeth 11 and 13 Fig. 13: Final check of the functional aspects. The veneers blend in with the dental arch naturally and “invisibly” 14 available CME 04-05 May 2018 Target Group: Dental technicians, Clinical dental technicians, Dental lab owners, Dental industry, Dental team Venue: Madinat Jumeirah Conference Centre, Dubai, UAE Accreditation: 14 CE Credits | Est. DHA 12 CME | Est. HAAD 14 CME FINAL PROGRAMME >>> CLICK HERE REGISTER NOW >>> CLICK HERE Final Programme 09:00 - 10:00 Aiham Farrah, CDT, Syria The Knows and How’s of Flawless Lab-Fabricated Dental Restorations 10:00 - 11:00 Philippe De Moyer, Belgium Innovative Method in Guided Surgery to Prepare Immediate Loading and Place Dental Implant 11:30 - 12:30 Rik Jacobs, The Netherlands 3D Printing on the Edge of Conversion 12:30 - 13:30 Eric Berger, France Aesthetic Realization with VITA: Cut Back on VITA Block 14:15 - 15:15 Jürgen Feierabend, MDT, Germany Improving patient care through modern technology 15:15 - 16:15 Chritopher Adamus, Denmark Digital Dentures – Complete story from scanning to manufacturing Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. CAPP designates this activity for 14 CE Credits Round Table Trainings TABLE 1 TABLE 2 TABLE 3 TABLE 4 TABLE 5 TABLE 6 Aiham Farah, CDT Syria Eric Berger, MDP France Philippe De Moyer Belgium Elie Elkhoueiry Lebanon Rik Jacobs The Netherlands Chritopher Adamus Denmark The White & Pink Esthetic in Ivoclar Porcelain System Aesthetic Realization with VITA: Cut Back on VITA Block Innovative Techni- The Real on “X" cians Practical Guide hybrid technic known on How to Make Immediate Loading on Dental Implant as REAX 3D Printing on the Edge of Conversion CAD Design Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: No Session Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Session A: 10:30 - 12:00 Session B: 12:00 - 13:30 Session C: 14:15 - 15:45 Session D: 15:45 - 17:15 Tel: +971 4 347 6747 | Mob: +971 50 2793711 | E: events@cappmea.com www.cappmea.com/dtim thin layer of ceramic material? The Enamel and Effect material concept of IPS e.max Ceram Selection provid- ed the solution to this conundrum. First, the basic tooth shade was determined, for which shade sam- ples mounted on a gingiva shield (Dragon Shade, Drachenberg & Bell- mann, Germany) were used (Fig. 3). Conventional shade tabs - without gingival section – may impair the re- sult. Already during the selection of the basic tooth shade, it became evi- dent that standard dentin materials would not be sufficiently intensive to reproduce the natural tooth shade due to the thin layer thickness with which the veneer had to be created. It was therefore decided to use the Enamel and Effect materials of the IPS e.max Ceram Selection range. Self-made shade samples were used as reference for the targeted selec- tion of the materials. Among others, the Light Reflector Effect material in shade cream should lead to the desired result (Fig. 4). In addition, three enamel shades were chosen. The intensive enamel shade “aqua” was selected to emphasize the blu- ish translucent areas along the mar- ginal ridges (Fig. 5). The enamel shade “apricot” should lend warmth to the incisal, enhance the translucency and heighten the chroma. In addition, the slightly greyish but still warm enamel shade “quartz” was chosen. Creating the veneers Refractory dies for teeth 13 and 11 were created with the help of the master model (Fig. 6). The dies were then soaked in water to prevent them from drawing moisture from the ceramic materials during the layering procedure (Fig. 7). The veneers were built up in layers in accordance with the shape defined by the mock-up (Fig. 8). No dentin ma- terial was used. The colour-intensive Effect shade “cream” was used for the dentin core replacement. The other Effect shades selected served to bring out the warm-translucent interplay of shades. It did not take long to build up the veneers in ceramic. However, the esthetic appearance of a restoration is not determined by the shade effect alone. Subtle, barely noticeable surface structures can underline the natural appearance of a restoration. Adequate time and attention was therefore dedicated to designing the surface morphology of the veneers. At the final firing, the ceramic surfaces were slightly smoothed and, once fired, refined by mechanical polishing. Polishing was carried out carefully by hand. Figure 9 shows that the teeth were suc- cessfully brought into alignment with the adjacent teeth to create a harmonious appearance. An initial evaluation in the dental lab showed that the veneers demonstrated a natural interplay of shades in spite of the thin material thickness (Fig. 10). However, the effect in the mouth will ultimately decide the success of the restoration. Seating the restoration and final result An essential aspect for the success of veneers is the cemen- tation procedure. No matter how brilliant the ceramic ma- terials are and how skilful the work of the dental technician is, if the shade of the adhesive cementation material is not chosen correctly, the joy of the “new smile” will be short lived. Variolink® II luting composite in shade neutral was used for incorporating the veneers. Prior to placing the ve- neers, they were tried in with try-in paste to confirm that the treatment goal had been achieved. Once the ceramic veneers and tooth surfaces were conditioned (Fig. 11), the veneers were bonded to the teeth. The result was impres- sive. Teeth 13 and 11 now blended in harmoniously with the rest of the dental arch (Fig. 2). The tooth shape was aligned with the shape of the adjacent teeth, while slightly asym- metrical contours supported the natural appearance of the restorations. The light-optical properties of the veneers left nothing to desire. The intrinsic interplay of shades and variations of translucency seen in the adjacent teeth were faithfully reproduced. After the functional criteria had been checked, the patient was discharged from the practice (Figs 13 and 14). Conclusion In principle, such challenges can only be met if the dental technician understands the light-optical properties of nat- ural teeth and is able to use appropriate ceramic materials. The procedure demonstrated in this report eliminated the need for dental technicians to mix the individual materials themselves. Suitable materials in the ideal shade could be applied “directly from the tub”. In this way, the balancing act between maximum esthetics and minimum invasive- ness was successfully and reliably accomplished. Carola Wohlgenannt, MDT Wohlgenannt Zahntechnik OG Kurze Gasse 2, 6850 Dornbirn, Austria team@wohlgenannt-zt.com | www.wohlgenannt-zt.com