When restoring upper central incisors, tooth design can be particularly challenging for these most visible of teeth. In this case, Michele Temperani and Dr. Francesco Argentino demonstrate how a minor correction can change a patient’s appearance and have an impact on how their character is perceived.
The aesthetic perception of dental technicians and dentists makes the difference between basic treatment and a perfect denture production. In addition to the aesthetics, a durable restoration also depends on the careful use of high-quality materials and optimal treatment of the soft tissue.
There are many examples of technically perfect restorations that unfortunately do not match the character of the patient, which is something that goes beyond just the static smile. Usually all that is needed to completely change the appearance of the smiling patient is a minor shape adjustment.
Atwo-day course on customised restorations of front teeth was held at the vocational school for master dental technicians of Duesseldorf. The attendees had to perform an aesthetic coating in ceramic and composite on three individual crowns with CAD/CAM structures.
As a pilot user, I have already been using the Vita’s Enamic hybrid ceramic (Panadent), which was launched in 2013, since 2011 (Fig. 1). Although I tend to be skeptical on principle regarding anything new, the special properties of this innovative material attracted my interest in this case. And in the meantime, the product has successfully proven its worth in chairside treatments in my practice. In this respect, the particularly easy and fast processing that it offers has turned out to be of enormous benefit. However, in order
to achieve perfect shade results, some experience was certainly required initially.
I feel it is important to lead off this article with a little history about myself, which will go a long way towards explaining my dental philosophies and my deep and long-term interest in rehabilitative and reconstructive dentistry. As a young man of 18, I was involved in a major car accident (involving over 65 vehicles).
In these past few years, we have had an increasingly frequent need to erform rehabilitations on patients
who have lost all optimal parameters, both aesthetically and functionally.
Therefore, when we prepare to restore a mouth and need to recover the lost vertical dimension, we must consider that the reconstruction must not only have an aesthetic value, but that we will also have to pay the utmost attention to the functional aspect.
The edentulous state affects many essential aspects of a patient's life, their masticatory and phonetic functions, their appearance and even their social relationships. Although the edentulous patient's rehabilitation can be successfully met thanks to a complete dental prosthesis, in some cases, however, problems of instability and poor retention can appear, primarily concerning the lower denture.
Patients are often hoping for an aesthetically pleasing treatment using minimally invasive methods. Surgical interventions are often completely refused. The case outlined below shows that a good result can be achieved even under these types of difficult conditions.
The 42-year-old patient approached our practice asking us to restore her old bridge treatment. The objective: to visually improve the anterior tooth aesthetics and to improve the patient's oral hygiene options (patient did not want a bridge).
Our patient, a female in her mid- 40’s, came into the laboratory for a custom shade matching appointment involving her two endodontically treated lateral teeth. The patient was very concerned about her restorations’ final color, especially since the stump color was dark due to the lab fabricated posts and cores placed by the dentist.
Dentists and their patients are increasingly demanding esthetic restorations that are also durable and strong in order to correct a variety of functional and appearance related problems. Fortunately, the combination of advanced technologies and enhanced materials is enabling dental laboratory technicians to predictably respond to these demands.
Among them is an advanced lithium disilicate ingot (IPS e.max Multi, Ivoclar Vivadent, Amherst, NY) that inherently demonstrates progressive chroma and opacity from the cervical to dentin areas, as well as lifelike translucency in the incisal region.
Since from the first pictures, you can notice, from an aesthetic point of view, some imperfections suffered by the patient who explicity asked a non-invasive and too long
Thanks to the photos, the first alginate impressions, the facial bow and the wax records it is possible to mount the models on the articulator and to consider, together with the dentist, the right treatment to execute and the kind of material to employ.
Occlusal raising and, therefore, retouching have always been very sensitive issues and often a source of great conflict between clinician and technician. So being able to
use a method that would allow us to avoid such interventions on the occlusal boards is a source of great satisfaction and absolute precision.
Furthermore, the fact of knowing that the models, created with such care from a morphologic/functional point of view and to which we dedicated so much time will not be "destroyed,"
brings us technicians satisfaction, and the incentive to produce even more accurate artifacts.