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One of the recurring themes, dominant, and not yet fully focused in our sector is the construction of large implant restorations, whether they are coated in resin or ceramic. For some years now in fact, the progress made in materials and regenerative techniques makes it possible to place implants where it would once have been impossible.
Thanks to this clinical acceleration, in the laboratory we often find ourselves having to resolve cases that are very complex to manage, both for the complexity of the design and for the technical difficulties in place to generate specific responses. There has been much debate about which was the best material for building these structures.
Cleaning of the facial defect
The bandage removal, which has to be done very cautiously and carefully, allows us to visually check the defect. Here one must ensure that all absorbable haemostatic material is carefully removed from the defect area with sterilized tweezers. Ointment residue and eschar, especially around implant abutments, are easily dissolvable
with antiseptic fluid or an application of corn oil.
It promotes the gentle removal of any crust deposits. Follow the above with an examination of the defect area for inflammation and possible visible wound infection along with checking implants and abutments for stability.
Cameras can see very far, that's why they can help us catch details that that would normally escape the naked eye. How many times have we caught details in a photograph that we had not noticed before? We consider a camera almost as an objective, impartial, and external “third eye” (Fig. 1).
Observing the images of our artefacts on the model and on-site stimulates our critical sense and trains the eye to notice details and search for a balance between prosthetics and aesthetics.
Therefore, photography and documentary techniques become crucial. Modern digital technology allows documenting our cases throughout every stage of the process. This is where our pathway: “observe, plan, create” stems from.
This article is an exploration with e.max Opal 1 ingot, e.max Value 3 ingot, and e.max ceram refractory veneers for a comparison in translucency, opacity and final aesthetics. The main purpose of this experiment was to test characteristics of these materials and determine when layering is necessary to mask underlying prep contours.
Creating a single anterior tooth crown and adapting it perfectly to the existing natural teeth is a challenge for any dental technician regardless of how often this task is performed. This example case involves the overlayering of a zirconium coping with Vita VM9, with the aim of approximating the natural tooth as accurately as possible in terms of shape, shade and surface structure.
The 25 year old female patient was not only missing her permanent laterals but her primary teeth as well. She was extremely shy and selfconscious in social situations because of her appearance and seldom smiled.
At the age of 8 she was given a palate expander and, later full orthodontics twice. The orthodontist attached false teeth to the wires, but they did not match in color or size. Her excess tissue had to be trimmed on several occasions. The brackets on the braces caused staining on her teeth which made her very selfconscious. At the age of 19, in 2006, implants were surgically placed and tissue re-contouring was performed four times. Infection occurred on the tooth number 7 implant which led to more delays.
Finally, in April of 2011, anterior restorations were to be placed. This was what the patient had been anticipating for many years. After all the suffering with social embarrassment, she was
more than ready to move forward and complete her smile.
Case Study 2 presents a cement-retained implant restoration with a Lava NeoLink Zirconia abutment5 topped with an e.max crown. Figure 26 shows the case prior to preparation. Due to the failure of the root on 21, extraction was necessary and an implant was placed (Fig. 27).
The patient had a high lip-line and high expectations for the outcome. Both the clinician and the patient were based in Melbourne. With the author (in his role as the ceramist) in Sydney, clear and detailed communication
between the patient, clinician, and ceramist was critical in the success of the case. The colour matching was achieved, even without seeing the patient, by using digital photographs taken by the clinician.
There are several studies that have been done on the effects of fluoride and its massive accumulation in the Pineal gland. As we know, the Pineal gland is a very important anatomical part of the animal body and is responsible for the production of serotonin and melatonin. It also regulates the maturation cycles in young males and females. Recent studies have shown that the age of maturation in human females is increasing and they are becoming adults so to speak, at a very young age. This observation alone has the anti-fluoridationists up in arms once again. Fluoride to this angry group is a poison and a pollutant. If fluoride can effect maturation cycles in the Pineal gland, what else can it do that is of a detrimental nature.
Nowadays every laboratory, with a differentiated list of services, needs a reliable and economic porcelain material for both basic and advanced level of PfM aesthetics. In light of the current financial state around the
world this necessity becomes even more pressing, raising demand for an easily affordable ceramic powder. It goes without saying that I myself was until recently on the hunt for just such a material. For it to serve my purposes the ceramic had to not only meet certain price criteria, but it also had to be very reliable and quite forgiving. After all, the last thing a dental technician wants is to invest more time in correcting defects or remaking his/her cheapest crowns. Over the years I’ve worked with a variety of hi-end porcelain fused-to-metal systems and have consistently provided my clinical clients with a steadily increasing level of natural aesthetic results. And every time I tried to incorporate a lower price crown and bridge service in my assortment I was
faced with the same problem: