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Nowadays, it is totally inadequate to speak about surface staining if we consider the new Lustre Pastes masses that are available. By using this technique it is possible to achieve a true stratification of colour if applied well. In fact, the homogeneity and penetration of the colour is extremely similar to the traditional layeringtechnique. By applying levels of coloured layering masses during the three baking stages, one can obtain a real and proper stratification.
The assimilation of this technique also allows the technician to establish over a period of time a more confident rapport with the traditional technique. This occurs because shortly after having utilized the stratified staining technique, one generally develops a greater awareness of colours, and hence its application, even in combination to the conventional stratification technique.
New materials, the increasing needs of patients, the economic crisis, and dental tourism are putting odontotechnical laboratories, their owners, and their partners under pressure. How can this challenge be met? A winning tactic in this battle is surely the product’s quality and Italian dental technicians and the “Made in Italy”have nothing to fear in this field. Client services and “teamwork” areanother two factors needed in facing future challenges. By illustrating the procedure in two clinical cases in the first part of this two-part article, the author shows how excellent results can be obtained.
A wide range of increasingly innovative and reliable materials is now available to satisfy the needs of both patients and dentists. Esthetics become absolutely subjective in a situation where there is strong emphasis on appearance and this is often difficult to communicate clearly and unequivocally to the patient. Looking through the wide range of prosthetic options, new methods are available for the heterogeneous manufacture of prostheses.
Moreover, using esthetic composite facets is increasingly convincing as its development has concentrated on using new alternative materials that are not to be undervalued. This new esthetic coating system manages to satisfy current esthetic standards with a modern design of its form and the vestibular surface structures. Lastly, the color can be chosen from sixteen of the most recognized ones in the Vita scale and as in the clinical case presented in this article, this color can be easily modified if necessary in order for it to be individually harmonized. The ease with which the system can be used satisfies every more or less artistic technician who works with this type of prosthesis, restoring the patient’s well-being in a predictable manner, improving efficiency and increasing production in our laboratories as well as contributing to improving the dental studio’s image in the eyes of an increasingly varied clientele. Consequently, technological evolution now permits the dental technician to use a valid succession of materials and take less time to produce standard units of undoubted quality.
Dental technicians very often like to define themselves as “artists”. It is true that they create, but their creations arise out of absolutely having to respect several rigorous parameters. Nevertheless, each individual dental technician can breathe life into their own style of working by drawing inspiration from their personal way of perceiving the reality that surrounds them, therefore discovering the pleasure of making excellent prostheses that satisfy the patient.
Description of a clinical case – The needs of both patients and dental personnel encourage the use of materials and techniques whose esthetic results are coming ever closer to perfection. The objective is to make a fixed prosthesis in zirconium oxide/ceramic for the price of a metal ceramic.
The clinical case presented in this article involved the manufacture of a prosthetic restoration with a framework made of zirconium oxide (Y-TZP) Cercon Smart Ceramics-Dentsply covered in pressed Press & Smile-Dentsply ceramic. The esthetics obtained using metal-free prostheses are better than those obtained using a traditional metal ceramic. The compromise of coating using the pressed ceramic technique also results in a restoration costing the same as a traditional prosthesis.
The role of communication has now become very important and awareness of this role has been growing during recent years.
When one speaks of communication, one immediately thinks of editorial communication, of the media, marketing, and the Internet. In reality, individuals communicate in every moment and in all sectors of their lives by exchanging knowledge and information.
The way in which we communicate is also the way in which we relate to others. The key to success lies in communicating in a simple and constructive manner, but above all by communicating with an interlocutor who is willing to listen. The best results are achieved when the communicator’s creative inspiration is added to the listener’s talent and communication.
In the field of dentistry, communication between the dentist and the dental technician is fundamental to an excellent prosthetic restoration . In particular, when there is a reciprocal exchange of information between the dentist and the dental technician concerning their respective competences, the patient is certainly the first to benefit. Consequently, it is essential for the dentist to know how to follow laboratory procedures in order to manufacture a prosthetic restoration and even engage him or herself in the manufacturing process in order to improve their understanding of the problems arising during the process and to solve them by working together with the dental technician.
As luck would have it, twenty years ago, when I arrived in the United States, I went to work at the dental clinic, Goldstein, Goldstein, and Garber considered by many one of the best dental clinics across North America. At that time GGG was considered the pioneer clinic of cosmetic dentistry.
Before arriving to Atlanta from Italy, I had used the platinum foil technique to fabricate jacket crowns, as it was customary in Europe. At that time, laminate veneers were virtually unknown to me, although it was very popular at Goldstein, Goldstein and Garber.
The esthetic and functional restoration of the stomatological apparatus is the ultimate objective of any prosthetic rehabilitation. The success of the dental treatment can only be obtained when the team, composed of the patient, prosthetist, and dental technician, are in full and harmonious agreement in planning and carrying out the various phases.
Positioning implants must not, in fact, be thought of as a surgical goal in itself because it is a necessary pre-condition for achieving the aim of anatomic and functional integrity of the stomatognathic apparatus (function).
For the prosthetic outcome to be a success, every phase in the prosthetic rehabilitation must be guaranteed (technical and clinical protocol), that is: a prosthetically guided positioning of the implant, correct choices made for the abutment, for the prosthetic superstructure, and for the esthetic coating materials, as well as an appropriate occlusal scheme having characteristics that guarantee good masticatory wear resistance.
We were lead to treat a 57 year-old female patient in order to find a solution to her mandibular clinical situation. Following the extraction of teeth 35 and 47, her present stellite no longer offers the function and stability required and moreover, the aesthetic aspect needed to be improved. The remaining teeth did not show any mobility and the patient’s overall health was good. A fixed restoration would have been possible, however, the patient did not want to undergo a tedious surgical treatment to install implants. Consequently, she chose a removable restoration with attachments, which was more suited to her wishes.
Among the challenging tasks facing dental ceramists is to accurately and predictably achieving a shade match to a single central incisor while spending as little time as possible at the bench. Unfortunately, techniques and materials that enable a guaranteed “what you see is what you get” result have been elusive—until recently. The introduction of a material called lithium disilicate (IPS e.max Press, Ivoclar Vivadent, Amherst, NY) allows ceramists to fabricate with enhanced productivity predictable esthetic restorations that demonstrate the combination of exceptional esthetics and high strength. The technique illustrated here represents a step-by-step process developed for use with the IPS e.max Press lithium disilicate material to accurately and predictably match a single central incisor in an efficient manner by mimicking the internal effects of a natural tooth. Further, the technique also involves creating a natural-looking optical effect by enameling over these characteristics to quickly and precisely return to full contour.
Although the technique is not illustrated on a real case, it does demonstrate the manner in which a complex central incisor (eg: tooth #9) can be recreated. Since the number of such detailed instructional articles in the literature is limited, readers should find this pictorial example beneficial.
Over the years, there have been many developments in restorative materials for aesthetic dentistry. While pressable ceramics and alumina porcelain, such as Procera have been clinically utilized for many number of years as alternatives to porcelain-fused-tometal, new materials like zirconia structures and porcelains are more widely available for use in the dental industry.
Through the continued evolution of these materials, as well as advancement of restorative techniques and laboratory fabrication procedures, dental professionals are provided with the necessary tools to treat patients requiring either replacement or enhancement of the natural teeth.
In order to maximize the potential of the vast array of options the technician must have an understanding of what the specifications of each material and technique are including possible limitations in order to achieve the best result for each particular application.
When restoring with laminate veneers there are also many different materials to choose from as well as available techniques. Depending on the purpose of the restoration from restoring color to the under layer or blocking out desired areas, it is in the hands of the dental restorative team to decide what is the best choice of options.