22 ◊Page 19 A conventional impression was taken of the prepared teeth and the casts were scanned. Prior to taking the impression, retraction cords (UltraPak; Ultradent) were placed for gingival retraction around the prepared teeth. Retained proximal contacts were separated with thin matrix strips. The impression was taking using and addition-type sili- cone at one time and in two phases (Aquasil; Dentsply Sirona; Fig. 7). The conventional impressions and casts facilitated the digital design process by providing a laboratory-made wax-up and subsequent adjustment of the restorations. This meant that hardly any intraoral adjustments were required. A transparent vacu- um-formed splint (Erkodent) was first made with the aid of the wax- up, allowing provisional resin resto- rations to be produced (Luxatemp; DMG). These were subsequently con- nected to the prepared teeth with Prime & Bond XP (Dentsply Sirona) and a flowable composite (Baseliner; Heraeus Kulzer). The restorations themselves were produced using the CEREC CAD/ CAM (Dentsply Sirona). To this end, the saw-cut models were scanned with a BlueCam (Dentsply Sirona; Fig. 8). The teeth of the wax-ups were copied digitally and used for the de- sign of the restorations (CEREC soft- ware v. 4.4 using the Biogeneric Copy option; Dentsply Sirona; Fig. 9). PROSTHETICS Dental Tribune Middle East & Africa Edition | 4/2021 The restorations were milled from blocks of a zirconia-reinforced lith- ium silicate (Celtra Duo; Dentsply Sirona) of A2 HT shade, finished with water-cooled diamond cutters and adapted on the model (Figs. 10 and 11). Having ensured that the restorations were clean and free of grease and residue, they were customized with stains and glaze and subsequently fired. A more intensive shade effect (Fig. 12) was achieved by repeating cycles of applying and firing the ma- terial. The first stain/glaze firing took place at 820°C and the second one at a lower 770°C. The restorations were tried in with the aid of a glycerine-based gel (Try- In; Ivoclar Vivadent). Care was taken to ensure a good marginal fit, cor- rect proximal contacts, a harmo- nious contour of the incisal edges and an appropriate shade. Minor corrections were carried out with a diamond cutter under irrigation, fol- lowed by polishing. After the try-in, the teeth were isolat- ed with rubber dam and cleaned. The ceramic restorations were etched on the adhesive surface using hy- drofluoric acid (Ultradent Porcelain Etch; Ultradent) for 30 seconds and conditioned with a silane solution (Calibra, Dentsply Sirona) for 60 sec- onds. The teeth were conditioned with 36% phosphoric acid (DeTrey Conditioner 36; Dentsply Sirona) for 30 seconds on the enamel and 15 sec- onds on the dentin and subsequent- ly with Prime & Bond XP + Self-Cure Activator (Dentsply Sirona). Calibra dual-curing resin cement (Dentsply Sirona) was used for adhe- sively cementing the full and partial crowns. The veneers were used with a light-curing cement (Calibra Esthetic Resin Cement, Dentsply Sirona). After thorough removal of any excess resin and light curing, the occlusion was checked and the restorations were polished (Figs. 13 and 14). The zirconia-reinforced lithium sili- cate ceramics are characterized by good polishability and shade adap- tation to neighbouring structures (Figs. 15 and 16). Summary ZLS ceramics already have a high strength after milling2 and can be cemented adhesively immediately after polishing. In the present case, however, we decided to work with the laboratory to provide the res- torations, since many restorations have to be made at the same time and since the aesthetic result and the mechanical strength of the ce- ramic could be further improved by additional stain and glaze firing. The digital design of several restorations was considerably facilitated by the laboratory-made wax-up. By adapt- ing the restorations on the model, the patient’s chair time could be reduced. Adhesive cementing with Calibra was a very pleasant process, since any composite residue was easy to remove and the optical prop- erties of the ZLS ceramic were not ad- versely affected. Very good aesthetic results can be achieved with ZLS even for monolithic ceramic restorations. ZLS ceramics have improved me- chanical properties compared to lithium disilicate ceramics3. Howev- er, only a few case reports on clinical use have become available so far2, 4. Clinical trials are still pending. References 1. Frankenberger R, Mörig G, Blunck U, Hajtó J, Pröbster L, Ahlers MO. Prä- parationsregeln für Keramikinlays und –teilkronen unter der Berück- sichtigung der CAD/CAM-Technol- ogie. J Cont Dent Educ. 2007; (6), 86–92. 2. Rinke S, Schäfer S, Schmidt A-K. Einsatzmöglichkeiten zirkonoxid- verstärkter Lithiumsilikat-Keramik- en. Quintessenz Zahntech. 2014; 40(5): 536-546. 3. Elsaka SE, Elnaghy AM. Mechani- cal properties of zirconia reinforced lithium silicate glass-ceramic. Dent Mater. 2016; 32(7): 908–14- 4. von der Osten P. Zirkonoxidver- stärktes Lithiumsilikat für die Seiten- zahnversorgung. Quintessenz Zahn- tech. 2014; 40(7): 900-904. Find out more by scanning the QR code. About the authors Clinician: Dr Tim Hausdörfer (Department of Pre- ventive Dentistry, Periodontology and Cariology, University of Göttingen, Ger- many) Dental technician: Joachim Riechel. M.D.T. (Center for Den- tistry and Oral and Maxillofacial Surgery, University of Göttingen) Address for correspondence: Dr Tim Hausdörfer, Poliklinik für Präven- tive Zahnmedizin, Parodontologie und Kariologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany. Tel: +49 551 3922877. E-mail: tim.hausdoerfer@med.uni-goet- tingen.de. Why emotional intelligence in dentistry is a vital skill emotional needs of the patients and adequately performing the required operational techniques”. return of investment on working to improve EI is far higher than that for working to increase one’s knowledge. By DTI LEIPZIG, Germany: Emotional in- telligence (EI) relates to the ways in which an individual can understand and manage his or her own needs as well as recognise and deal with the needs of others and the abilities to do this. As a dental professional, these are important skills to have because every activity during a treat- ment process requires connecting emotionally with patients, and those who can put their EI into practice ef- fectively will be more successful in the long run. Even though dental professionals work with people all day, they are not necessarily the best at doing so and often lack EI. For example, a study, ti- tled “Emotional intelligence among dental undergraduate students: An indispensable and ignored aspect in dentistry”, showed that only 11.55% of 186 undergraduate dentistry students who were questioned in a survey had good EI. In a paper on the topic "Emotional Intelligence and Dentistry", author Dr Mohlab Al-Sammarraie stated that, as a den- tist having many years of leadership experience, he believes “that sustain- able progress of the profession de- pends on the ability of all dentists to strike a balance between meeting the Is trying to increase one’s knowl- edge a waste of time? What Al-Sammarraie is referring to here is the combination of EI and intelligence quotient (IQ). This rela- tionship has been extensively estab- lished, and studies have shown that IQ correlates with cognitive control abilities. In summary, research sug- gests that EI matters more than tech- nical competence when it comes to being a successful manager, that individuals with better social skills make better decisions and that the k c o t s r e t t u h S / c i h p a r G a m n i l This might be a hard pill to swallow for practitioners who love to refine their operative techniques (or what- ever their aim might be) to utmost perfection. In fact, those technical skills are worth very little when they cannot be put into practice because dentists cannot connect with their patients emotionally and continu- ously encounter frustrating recur- ring leadership and staff problems. EI is central to success The good news is that EI can be learned. EI is described as the exist- ence of four dominant behavioural traits called self-awareness, social awareness, self-management and the ability to manage relationships. The following paragraphs investi- gate each characteristic and consider some tips as to how those traits can be translated into everyday work life at a dental practice. Self-awareness Self-awareness is the foundation for being a good leader, but it requires self-reflection. Assessing oneself objectively daily can be a good way to understand strengths and weak- nesses that were shown in certain situations throughout the day. Ask- ing trusted co-workers to describe oneself can also be a good source of insight. Another great tip is to keep a journal where goals, plans and priori- ties can be written down for future reference. Social awareness To be more socially aware and, essen- tially, a better leader, it helps to prac- tise some observational skills which include learning to understand what it means to truly listen to others. In order to do that, it is essential to pay attention to other people’s tone of voice, watch facial expressions and body language, develop a feeling for the general mood in the office, and try to notice the fine details which can make a considerable difference. Self-management Often before someone has the capa- bility to concentrate on others and pay attention to the seemingly sub- tle things that happen in a practice, he or she needs to gain control of his or her own workload. Planning for each workday and coming to meetings prepared can make a big difference and provide a feeling of control. Another great way to prac- tise self-management is to set a goal, focus the attention on this one task, reflect on the task and then, mind- fully, move on. Ability to manage relationships All these tips should ultimately help to improve relationships around the workplace because people who work on themselves develop a better un- derstanding of what is going on in- side the heads of the people around them. To deepen connections with co-workers, it is important to iden- tify relationship needs, manage boundaries, appreciate others and schedule time to build relationships. Essentially, the reason why EI is cen- tral to one’s success is that more real- world problems can be solved with people skills rather than with pure intelligence. Luckily, everyday life has many situations in store where all four dominant behavioural traits can be practised. Studies have shown that emotionally intelligent people are more likely to be successful in both their personal and professional lives. i ©