Clinical Cases and Labside

Keeping it smart and simple: Micro-layering of implant supported reconstructions

Case by Andreas Chatzimpatzakis

Many modern, tooth-coloured dental materials enable us to achieve more with less. By using high-strength ceramics with a multi-layered colour structure and natural translucency, for example, the path to the desired outcomes involves fewer components, smaller layers and a reduced number of bakes. A possible streamlined procedure is illustrated below. The main materials used were KATANA™ Zirconia HTML PLUS for the screw-retained implant-supported superstructure and CERABIEN™ MiLai (both Kuraray Noritake Dental Inc.) for vestibular micro-layering.

Fig. 1. Zirconia-based screw-retained implant-supported prosthesis after milling and carving to obtain a natural surface texture.

Fig. 2. Restoration after sintering. To intensify the colour characteristic of the multi-layered blanks, the surface was treated with Esthetic Colorant (mainly in the incisal area and the gum parts).

Fig. 3. Appearance after the application of CERABIEN™ MiLai SS Fluoro.

Fig. 4. Restoration after the application of CERABIEN™ MiLai internal stains. They add some natural shading effects to the tooth and gum areas.

Fig. 5. Restoration on the model after micro-layering. In the cervical area, CERABIEN™ MiLai LT1 was mainly used, while the middle and incisal areas were individualized with E2 and Tx, the latter adding a seamless gradient in translucency. For the gingiva, the choice fell on the tissue porcelains 1, 5 and 6.

Fig. 6. Finished restoration on the model.

Fig. 7. The micro-layer of porcelain has a brilliant effect.

Fig. 8. The lifelike appearance is due to a smart combination of surface texturing …

Fig. 9. … and micro-layering with a comprehensive set of internal stains plus porcelains.

CONFIDENCE AND CONTROL

Full ceramic layering can produce beautiful results, but can be quite complex and time-consuming. In times with limited availability of skilled personnel and high-performance materials being offered, it may be a valuable strategy to opt for micro-layering with CERABIEN™ MiLai whenever appropriate. The system provides precise control over the layering and shading procedure, so that highly aesthetic and functional outcomes are easily and confidently obtained.