Digital Workflow for Virtually Designing and Milling Ceramic Lithium Disilicate Veneers: A Clinical Report

2015 ◽  
Vol 40 (3) ◽  
pp. 241-246 ◽  
Author(s):  
A Zandinejad ◽  
WS Lin ◽  
M Atarodi ◽  
T Abdel-Azim ◽  
MJ Metz ◽  
...  

SUMMARY Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.

2014 ◽  
Vol 40 (5) ◽  
pp. 593-600 ◽  
Author(s):  
Sompop Bencharit ◽  
Michael B. Border ◽  
C. Russell Mack ◽  
Warren C. Byrd ◽  
John T. Wright

Dentinogenesis imperfecta (DI) is a genetic disorder affecting the structural integrity of the dentin that can result in weakened dentin. The affected teeth, especially posterior teeth, often need to be extracted due to severe wear or fracture. This frequently yields a loss of posterior occlusion and occlusal vertical dimension. Besides wear and fracture, anterior teeth often have an unesthetic appearance because of discoloration. Current treatments of choice, including composite bonding restorations and, more recently, all-ceramic restorations, are typically suggested to preserve the remaining teeth and tooth structure. However, there are a limited number of studies on dental implants in patients with DI. The effectiveness of dentin bonding and dental implants in patients with DI is not known. This clinical report describes a 32-year-old Asian woman with DI who underwent full-mouth rehabilitation. The posterior occlusion, mostly in the molar areas, was restored with dental implants and ceramometal restorations. The anterior teeth and premolars were restored with bonded lithium disilicate glass-ceramic pressed veneers and crowns made with computer-aided design/computer-aided manufacturing. This case demonstrates that restoring functional occlusion and esthetics for a patient with DI can be completed successfully using contemporary implant therapy and adhesive dentistry.


2018 ◽  
Vol 12 (04) ◽  
pp. 590-593 ◽  
Author(s):  
Tassiana Cançado Melo Sá ◽  
Monize Ferreira Figueiredo de Carvalho ◽  
Julio Celso M. de Sá ◽  
Claudia Silami Magalhães ◽  
Allyson Nogueira Moreira ◽  
...  

ABSTRACTThis clinical report describes an 8-year follow-up evaluation using different thicknesses of porcelain laminate veneers of diastema and malformed anterior teeth. Minimally invasive treatment with no preparation or minimal reduction options could be considered and chosen based on the characteristics of each case. Laminate veneers with or without reduction can offer an excellent result regarding esthetics and function. Despite its failure without reduction, this treatment is indicated because it can be applied regardless of the structure of the teeth. At first, no tooth preparation with rotatory instruments was performed, and porcelain laminates of minimum thickness were made for the four maxillary anterior teeth. After 6 years, the adhesive interfaces were stained, and the patient was unsatisfied with the esthetics of her smile. Therefore, at that time, the professional decided to prepare the anterior teeth for porcelain laminate veneers. Diastema closure and/or correction of malformed anterior teeth using porcelain laminate veneers is a viable option for the clinician because it restores esthetic harmony. The patient was very pleased with the new laminate veneers.


Author(s):  
Fariborz Vafaei ◽  
Alireza Izadi ◽  
Samaneh Abbasi ◽  
Maryam Farhadian ◽  
Zahra Bagheri

Objectives: This study aimed to compare the optical properties of Zolid FX, Katana UTML, and lithium disilicate laminate veneers. Materials and Methods: In this in-vitro experimental study, the maxillary left lateral incisor of a phantom received a laminate veneer preparation. An impression was made, and a die was fabricated using dental stone. The die was scanned using a computer-aided design/computer-aided manufacturing scanner. Ten dies were fabricated from each of the A1, A2, and A3 shades of composite resin. Laminate veneers were fabricated using A1 shade of Katana UTML, Zolid FX, and IPS e.max CAD ceramics (n=10) and placed on composite abutments using bleach and white colors of trial insertion paste (TIP). The optical properties were measured at the incisal, middle, and cervical thirds using a spectrophotometer. Data were analyzed using three-way analysis of variance and Tukey’s test. Results: The effect of laminate material on the L*, a*, and b* parameters was significant in all areas (P<0.001), except for the L* parameter in the middle and cervical thirds. All color parameters were affected by TIP color in all three regions in most samples (P<0.05). The effect of composite abutment shade was also significant in most cases (P<0.05). The effect of laminate material, abutment shade, and TIP color on the b* parameter was significant (P<0.001). The L* parameter was almost the same in the two zirconia and lithium disilicate ceramic groups. Conclusion: The composite abutment shade, TIP color, and laminate material should be carefully selected to achieve optimal aesthetics in laminate veneers.


2016 ◽  
Vol 41 (6) ◽  
pp. 666-671 ◽  
Author(s):  
C Gillette ◽  
R Buck ◽  
N DuVall ◽  
S Cushen ◽  
M Wajdowicz ◽  
...  

SUMMARY Objective: To evaluate the significance of reduced axial wall height on retention of adhesively luted, all-ceramic, lithium disilicate premolar computer-aided design/computer-aided manufacturing (CAD/CAM) crowns based on preparations with a near ideal total occlusal convergence of 10°. Methods: Forty-eight recently extracted premolars were randomly divided into four groups (n=12). Each group received all-ceramic CAD/CAM crown preparations featuring axial wall heights of 0, 1, 2, and 3 mm, respectively, all with a 10° total occlusal convergence. Scanned preparations were fitted with lithium disilicate all-ceramic crowns that were luted with a self-etching resin cement. Specimens were tested to failure at a 45° angle to the tooth long axis with failure load converted to megapascals (MPa) based on the measured bonding surface area. Mean data were analyzed using analysis of variance/Tukey's post hoc test (α=0.05). Results: Lithium disilicate crowns adhesively luted on preparations with 0 axial wall height demonstrated significantly less failure resistance compared with the crowns luted on preparations with axial wall heights of 1 to 3 mm. There was no failure stress difference between preparations with 1 to 3 mm axial wall height. Conclusions: Under conditions of this study, adhesively luted lithium disilicate bicuspid crowns with a total occlusal convergence of 10° demonstrated similar failure resistance independent of axial wall height of 1 to 3 mm. This study provides some evidence that adhesion combined with an ideal total occlusal convergence may compensate for reduced axial wall height.


2015 ◽  
Vol 40 (4) ◽  
pp. 350-356 ◽  
Author(s):  
T Abdel-Azim ◽  
A Zandinejad ◽  
M Metz ◽  
D Morton

SUMMARY Interdisciplinary treatment planning is necessary in certain clinical situations to optimize esthetic treatment outcomes. Patients presenting with severe wear of their anterior teeth from iatrogenic influences pose a particularly difficult problem in terms of esthetic treatment planning. Collaboration of practitioners from the disciplines of orthodontics, periodontics, and restorative dentistry is essential for the treatment of patients with complex esthetic dental needs. Careful assessment of clinical situations and corresponding specialty consultations are of utmost importance to achieve more predictable and esthetic treatment outcomes. The purpose of this clinical case is to report to the readership a novel digital fabrication of computer-aided design/computer-aided manufacturing milled acrylic provisional restorations and final lithium disilicate definitive restorations after orthodontic and periodontal therapy with virtual master impressions, casts, and articulation.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Sapna Rani ◽  
Jyoti Devi ◽  
Chandan Jain ◽  
Parul Mutneja ◽  
Mahesh Verma

Digitalization has become part and parcel of contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in the near future. This digital revolution started in the latter half of the 20th century by converting analog objects/signals into digital bits and bytes. Recent developments in all-ceramic materials and systems of computer-aided designing and computer-aided manufacturing (CAD/CAM), copy milling, and so forth offer excellent esthetics and superb biocompatibility. Copy milling system for ceramics enables milling of the zirconia cores of all-ceramic restorations precisely and also if this system is properly used the procedure for fabricating all-ceramic restorations can be substantially simplified. This case report presents fabrication of all-ceramic Maryland Bridge and post-core with a copy milling system for esthetics and preservation of integrity of tooth. For both of the patients, the use of biologic, all-ceramic, copy-milled restorations resulted in clinical success and recovered function and esthetics.


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Daniela Micheline dos Santos ◽  
Amália Moreno ◽  
Aljomar José Vechiato-Filho ◽  
Liliane da Rocha Bonatto ◽  
Aldiéris Alves Pesqueira ◽  
...  

The success of rehabilitation will not depend on just clinical procedures. A proper dental technique (ceramist) is required as well as the respect for some biomimetic principles to obtain the desired final result. This study has the purpose of describing a prosthetic rehabilitation with laminate veneers and all-ceramic crowns of a patient unsatisfied with a previous esthetic treatment because of the negligence of some biomimetic principles. A 45-year-old female patient was admitted to the dental clinic complaining about the lifelike appearance of her all-ceramic restorations. Before the fabrication of new restorations, a mock-up was conducted to verify the patient’s satisfaction. A ceramist conducted all the fabrication process so that surface characterizations could be visually verified and the lifelike appearance of natural tooth could be reproduced. After the cementation procedure, the patient reported being satisfied with the lifelike appearance of the new restorations. Based on the clinical findings of the present case report, it can be concluded that the reproduction of the lifelike esthetic appearance of natural teeth and the visualization of the final results before definitive procedures are essential to obtain the clinical success.


Author(s):  
Dileep Soni ◽  
Ashwani B Prasad

ABSTRACT The use of porcelain laminate veneers to solve esthetic and/or functional problems has been shown to be a valid management option, especially in the anterior esthetic zone. In cases when patients decline orthodontic treatment, adhesively bonded porcelain veneers are a reliable treatment option to modify the appearance of tooth position and form, to close diastema or cervical embrasures, or to change the tooth shade. Porcelain veneers are one of the best corrective options available considering biological, functional, mechanical, and esthetic points of view. The present case report is about discolored anterior teeth in a healthy dentition by means of sectional porcelain veneers simply cemented onto the natural teeth and with minimal tooth preparation. How to cite this article Soni D, Raisingani D, Prasad AB, Mital P, Srivastava H, Dixit A. Smile Design with All Ceramic Veneers. J Mahatma Gandhi Univ Med Sci Tech 2017;2(1):51-54.


2020 ◽  
Vol 8 (10) ◽  
Author(s):  
Paula Mayumi Siqueira ◽  
Fábio Eduardo de Siqueira ◽  
Edson Suguiama ◽  
Gabriel Marcondes Castanheira ◽  
Fernanda Midori Tsuzuki ◽  
...  

Introdução: O restabelecimento de um sorriso harmônico constitui um grande desafio para a odontologia restauradora. A sincronia entre diversas especialidades se faz necessária para diagnosticar e tratar alterações estéticas, buscando a excelência do resultado e a satisfação do paciente. Um método bastante citado na literatura e aplicado por muitos clínicos é baseado na teoria da regra de proporção áurea. Quando adotada para situações complexas a proporção áurea pode ser um ponto de referência para a reabilitação. Deste modo, o trabalho tem como objetivo demonstrar uma reabilitação estética de diastemas múltiplos após tratamento ortodôntico, por meio de laminados vitrocerâmicos reforçados com dissilicato de lítio, onde o conceito de proporção áurea é aplicado. Descrição do caso clínico: Primeiramente, o plano de tratamento consistiu na distribuição uniforme dos diastemas, sendo posicionados da maneira mais harmônica e favorável para a oclusão na reabilitação com laminados vitrocerâmicos. A segunda fase consistiu na cimentação dos laminados, a fim de obter um resultado estético agradável. Discussão: A associação de ortodontia prévia a instalação dos laminados, permite uma melhor harmonia estética e oclusal, garantindo uma longevidade do tratamento. Opções restauradoras como laminados vitrocerâmicos reforçados com dissilicato de lítio permitem reabilitações extensas minimamente invasivas. Para casos complexos a proporção áurea, quando alinhada com os conceitos de macro e microestética, pode levar ao sucesso estético.Descritores: Estética Dentária; Facetas Dentárias; Diastema.ReferênciasSoares GP, Silva FAP, Lima DANL, Paulillo LAMS, Lovadino JR. Prevalência da proporção áurea em indivíduos adultos-jovens. Rev odonto ciênc. 2006;21:346-50.Higashi C, Amaral RC, Hilgenberg SP, Gomes JC, Hirata R, Loguercio R, et al. Finalização estética em dentes anteriores pós tratamento ortodôntico: relato de caso clínico. Int J Bras Dent. 2007;3:388-98.Kalia A, Mirdehghan N, Khandekar S, Patil W. Multi-disciplinary approach for enhancing orthodontic esthetics - case report. Clin Cosmet Investig Dent. 2015;13:83-9.Otani T, Raigrodski AJ, Mancl L, Kanuma I, Rosen J. In vitro evaluation of accuracy and precision of automated robotic tooth preparation system for porcelain laminate veneers. J Prosthet Dent. 2015;114:229-35.BaratierI LN. Estética: restaurações adesivas diretas em dentes anteriores fraturados. São Paulo: Santos Editora; 1998.Levin, EI. Dental esthetics and the golden proportion. J Prosthet Dent. 1978;3:244-52.Siqueira PM, Nahsan FPS, Naufel FS, Formighieri LA, Schmitt VL. Incidência da proporção áurea regressiva após tratamento ortodôntico. Rev Odontol Bras Central. 2012;21:515-18.Melo GFB, Menezes Filho PFM. Proporção áurea e sua relevância para a odontologia estética. Int J Dent. 2008;7:234-238.Oliveira VLR. Estudo da proporção áurea entre incisivos centrais. SOTAU R. Virtual Odontol. 2008;5:2-6.Proffit W, Fields HW, Sarver DM. Contemporary orthodontics Fourth edition. Oxford: Elsevier Health Sciences; 2006.Moon JE. Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers: a case report. J Adv Prosthodont. 2010;2:61-63.Keene HJ. Distribution of diastemas in the dentition of man. Am J Phys Anthropol. 1963;21:437-41.Nagalakshmi S, Sathish R, Priya K, Dhayanithi D. Changes in quality of life during orthodontic correction of midline diastema. J Pharm Bioallied Sci. 2014;6:162-64.Jacobson N, Frank CA. The myth of instant orthodontics: an ethical quandary. J Am Dent Assoc. 2008;139:224-34.Bona AD. Bonding to ceramics: scientific evidences for clinical dentistry. São Paulo: Artes Médicas; 2009. p. 91-132.Griggs JA. Recent advances in materials for all-ceramic restorations. Dent Clin North Am. 2007;51:713-27.Gurel G, Sesma N, Calamita MA, Coachman C, Morimoto S. Influence of enamel preservation on failure rates of porcelain laminate veneers. Int J Periodontics Restorative Dent 2013;33:31-9.Vargas MA, Bergeron C, Diaz-Arnold A. Cementing all-ceramic restorations: recommendations for success. J Am Dent Assoc. 2011;142:20-24.Runnacles P, Correr GM, Baratto Filho F, Gonzaga CC, Furuse AY. Degree of conversion of a resin cement light-cured through ceramic veneers of different thicknesses and types. Braz Dent J. 2014; 25:38-42.Almeida JR, Schmitt GU, Kaizer MR, Boscato N, Moraes RR. Resin-based luting agents and color stability of bonded ceramic veneers. J Prosthet Dent. 2015;114:272-77.Marubayashi AMW, Shinike, AY, Terada, HH, Kurihara, E, Terada RSS. Avaliação da proporção áurea em pacientes submetidos ou não a tratamento ortodôntico. Rev Dental Press Estét. 2010;7:72-80.Morley J1, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc. 2001;132:39-45.Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod. 1999;21:517-22.Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent. 1999;11:311-24.


2021 ◽  
Vol 38 (SI-2) ◽  
pp. 143-147
Author(s):  
Çağrı URAL ◽  
Necati KALELİ

Every day, modern dentistry faces with new technologies, which have begun to be used in daily clinical practice, and computer-aided design and computer-aided manufacturing has brought new technologies and opportunities to all fields of dentistry. The first step is acquiring the true data, which belongs to the patients, digitalization of intraoral structures. By acquiring these data, the restorations can be designed and fabricated by using digital workflow. Dentists have two main options for capturing the data from the related surfaces; one is the direct digitalization and the other one is the indirect digitalization process. In the indirect process, extraoral scanners, which are called lab scanners or cast scanners, are used. Every system has different advantages and disadvantages, and the clinicians or dental technicians should know the technology and different features of these devices to choose the optimal device for their workflow.


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