Case by Dr. Yohei Sato, DMD, PhD, Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine, JAPAN and Dr. Keisuke Ihara, CDT, i-Dental Lab, JAPAN

Fig. 1. The patient was referred to our hospital by an orthodontist. The chief complaints were improper esthetics of the teeth due to black triangles at the edges of the gaps between the teeth and occlusal wear of the teeth.

Fig. 2. On the basis of the pre-treatment diagnosis using a mockup, the abutments were prepared without anesthesia, keeping in mind that the enamel should be preserved to the extent possible.

Fig. 3. Since a fixation retainer was installed on the palate side, it was difficult to take impressions using silicone. Therefore, an intraoral scanner for impression taking was used.

Fig. 4. A layer of porcelain on each of KATANA™ Zirconia STML substrates was applied to complete the laminate veneer resto-rations. The inner surface of each restoration was sandblasted, being careful to prevent chipping.

Fig. 5. After trial fitting, bonding inhibiting substances as blood and saliva were removed using KATANA™ Cleaner.

Fig. 6. Milling. CLEARFIL™ CERAMIC PRIMER PLUS, which contains the phosphoric ester monomer MDP, was applied and dried using compressed air.

Fig. 7. The surface of each tooth was cleaned and treated with K-ETCHANT Syringe for 10 seconds before washing it away with water and compressed air-dried the area.

Fig. 8. PANAVIA™ V5 Tooth Primer was applied and left it for 20 seconds, then compressed air-dried it.

Fig. 9. PANAVIA™ Veneer LC Paste was applied and the laminate veneer was seated. For this case, we treated six teeth during one session.

Fig. 10. The unpolymerized excess paste was removed with a brush. PANAVIA™ Veneer LC Paste is a light-cured type, which was designed to provide sufficient working time.

Fig. 11. This photo shows the results after the final light curing. Since the excess cement was easily removed, there were almost no cement residues.

FINAL SITUATION

Fig. 12. The photo shows the inside of the oral cavity one month after the fitting of the laminate veneer restorations. It can also be noted that the teeth’s marginal gingiva has been improved, thanks to the good fit of the laminate veneer restorations.

The vacation period is over and we all are slowly returning back to our everyday routines and work. With all the travel and holidays in the last months you might have missed this great article in the LabLine Summer edition: Graftless solutions and implant-supported monolithic zirconia fixed prostheses.

It is an extensive, beautiful and detailed case report created and documented by team of well known and respected KOLs: Fortunato Alfonsi, Antonio Barone, Marco Stoppaccioli, Romeggio Stefano and Vincenzo Marchio.

Check it out by clicking here.

Daniele Rondoni, hammasteknikko (CDT)

Tavallisesti hammaskeraamin esteettisyyttä – erityisesti sen läpikuultavuutta – voidaan parantaa vain taivutuslujuuden kustannuksella. Kararay Noritake Dental -yhtiön Uusi KATANA™ Zirconia on erilainen. Rungon alaosan taivutuslujuudella 1,100 MPa:a ja korkealla läpikuultavuudella rungon yläosassa ja inkisaalisesti esteettisyydelle ei ole indikaatiorajoja, kuten alla oleva tapaus osoittaa.

Kuva 1. KATANA™ Zirconia YML -materiaalista toteutetut 4-osaiset ja 6-osaiset sillat jyrsinnän ja sintrauksen jälkeen. Vestibulaaripinnan luonnollinen rakenne on tärkeä edellytys monoliittisten restauraatioiden esteettisyydelle.

Kuva 2. Kahden sillan frontaalinäkymä mallin päällä CERABIEN™ ZR FC Paste Stain -tuotteen (Kuraray Noritake Dental Inc.) ultramikrokerroksen levittämisen jälkeen.

Kuva 3. Värjätyt ja lasitetut restauraatiot ja niiden läpikuultavuus valossa.

Kuva 4. Potilaan suuhun sementoidun 6-osaisen sillan bukkaalinäkymä.

Kuva 5. Potilaan suuhun sementoidun 6-osaisen sillan bukkaalinäkymä.

Tämän uudentyyppisen monikerroksisen zirkoniumoksidin avulla voidaan valmistaa esteettisiä monoliittisia restauraatioita myös etualueella. Eri kerrosten lujuuseroista huolimatta materiaalilla voidaan toteuttaa lujuudeltaan erinomaisia restauraatioita ja materiaalin hyvä läpikuultavuus inkisaalialueella takaa luonnollisen lopputuloksen sintrauksen jälkeen. Ultramikrokerrokset ja monoliittisen pinnan lasitus takaavat lopputuloksen, johon potilaat ovat tyytyväisiä.

DANIELE RONDONI, MDT