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Although balancing esthetic outcomes and fulfilling the doctor’s desires for the most robust restorations has been a challenge, Chris Roman, CDT, has seamlessly integrated the new IPS e.max Multi from Ivoclar Vivadent into his daily workflow.
With today’s focus on highly cosmetic restorations and appliances, patients want functional, natural-looking removable partial dentures. Proper material selection is a key part of ensuring patient satisfaction.
Rejuvenation dentistry is an approach based on a model of health that considers not only a patient’s teeth but the entire masticatory system, including jaw joints, nerves and head and neck muscles, and maintains that problems occur when these components aren’t working in biological harmony.
Step ToothMaster Bay, CDT, DTG, discusses his technique for restoring the six anterior teeth for a patient who wanted to replace discolored anterior teeth with crowns that matched her natural A1 shade.
By Renato Carretti
A female patient, approximately 65 years old, presented with tooth #10 fractured down to the root; it was extracted and an implant was seated. She had had a gold filling on tooth #9 for nearly 45 years, and couldn’t imagine her appearance without it.
Although the gap following implantation was not provisionally restored, the gingival situation was excellent (see Figure 1). During the intraoral try-in, the crown showed good results in the cervical gingiva as well as good fit and shade match.
Optimizing the Surface
It’s not possible to recreate the surface of a crown...January 13 at 11:14 am in How to Use VITA VM 13 for Challenging Anterior Metal-Ceramic Restorations
By Renato Carretti
An approximately 50-year old patient presented with a fracture on tooth #9 (see Figure 1). Since the root was also fractured, the tooth was extracted and a clasp-retained provisional restoration was seated (see Figure 2).
The gingival papilla was prepared prior to placing the implant in order to ensure subsequent seamless progress of the case. After placing the implant, sufficient time was left for the gingiva to regenerate, which was in perfect condition after healing (see Figure 3).
The challenging aspect of this case was to match the transparency of tooth...January 13 at 11:06 am in How to Use VITA VM 13 for Challenging Anterior Metal-Ceramic Restorations
By Renato Carretti
A patient who was approximately 45 years old presented with a devitalized tooth #10 with dark discolorations (see Figure 1). This was a classic case for a metal-ceramic restoration because the discolored tooth stump would show through an all-ceramic restoration and make the crown look grey.
With this VM 13 crown, the goal was to reproduce numerous small enamel cracks, mamelons and decalcification marks like those of the adjacent tooth #9 (see Figure 2). After the first firing, Interno 1 (white smoke) was inlaid for the small enamel cracks; Interno 2 (sand) was used to emphasize...January 13 at 10:56 am in How to Use VITA VM 13 for Challenging Anterior Metal-Ceramic Restorations
- December 2014
A successful model-free process requires a reliable material, a highly skilled technician, excellent software and an outstanding mill. Here’s Bob Williams’ step-by-step technique for a recent case.
- November 2014
Jeff Smith, CDT, offers a step-by-step look at how to fabricate esthetic, monolithic restorations in a single press sequence with subsequent glazing using Ivoclar Vivadent’s new IPS e.max Press Multi.
Here’s a look at how using the split file technique and the digital, model-less workflow available from Core3dcentres—a digital design and manufacturing center with locations in seven countries that serves laboratories and dentists—met the needs of a time-sensitive implant patient.
- October 2014
Laboratory Owner Michael Suris has recently started using Strategy Milling©’s services to mill full contour gold crowns and bridges for Dental Professional Labs, Inc. in Merrillville, IN. He offers a step-by-step look at fabricating a milled gold posterior crown.
After watching technicians drop one too many crowns and losing productivity, Ceramist Tom Greggs invented Stabiliner, which reduces the risk of slippage of milled restorations during contouring/finishing procedures.
- September 2014
Jean Chiha, CDT, shares his step-by-step process for fabricating a posterior, three-unit, implant-supported bridge using Noritake KATANA Multi-Layered (ML) Zirconia.
The challenging aspect of this case was that one of the implants was improperly placed between #7 and #8. Steve Lee explains how he made a screw-retained zirconia framework with pink gingiva tissue to recreate the lost gingiva and then cemented on four single crowns made from IPS e.max to the framework.
- August 2014
In order to provide patients with a good color match for their restorations, I’ve found I need to do more than work with traditional shade tabs and photos. Here is my step-by-step technique for a 60-year-old patient who needed endodontic treatment and crowns on #9 and #10.
- June 2014
Bart Hyde, Hyde Dental Prosthetics in Fallon, NV, took first place in the 2014 North American Art of Denture Competition. Hyde offers a step-by-step look at his winning entry and his creative thought process.
- May 2014
- April 2014
All day Friday, the LB Promenade was buzzing with LAB DAY attendees trying to get a look at the display of 28 entries in the second North American Art of Denture (KunstZahnWerk®) Competition, sponsored by Ivoclar Vivadent and LMT.
During the Friday afternoon award ceremony, Sarah Anders, Ivoclar Vivadent’s new Senior Vice President of North American Sales, was on hand to congratulate the winners. “The Art of Denture Competition allows us to celebrate the incredible skills of dental technicians from across North America. The winners continue to amaze us with their abilities and creativity,”...
- February 2014
Renfert’s Cim Ozyurt explains the R&D behind lay:art style brushes, designed to fulfill all the requirements of optimal porcelain buildup.
- January 2014
The female patient was previously restored with less than ideal esthetic and functional results. When the old restorations were removed, the canine preps were very dark.
Zirkonzahn’s Georg Walcher, MDT, offers his step-by-step technique for rehabilitating an edentulous patient with implants and fixed Zirconia Prettau Bridges.
- November 2013
How to Match Central Incisors Using a Jacket Crown and Laminate Veneer Made With Noritake EX-3 Porcelain
Mismatched central incisors are a relatively common scenario, and a source of distress to the patient. Despite the high occurrence of these cases, it remains technically challenging for the technician and dentist alike to restore two central incisors that are esthetically balanced while being true to form and function. In addition, the complexity of the case is magnified by the fact that very often, each incisor requires different treatment.
co-authored by Dr. Rebecca Sharif; clinical case by Dr. Efim Fichman, DDS
To read more about the Noritake Dental Supply Co., Ltd. and Kuraray Medical Inc. merger, click here.
DENTAL TEAM: Scott Atkin, Creative Dental Laboratory and Dr. Michael Foley, both in Scottsdale, AZ
RESTORATIVE PROBLEM: A 79-year-old male patient with an existing PFM full mouth rehab needed a classic A3 shade replacement bridge for teeth #11 through #15.
TREATMENT PLAN: A five-unit Crystal Diamond full contour bridge was prescribed. Crystal Diamond was chosen for its excellent translucency and strength, ideal for highly esthetic anterior and posterior metal-free restorations.
FABRICATION PROCESS: The case was scanned using a 3Shape D710 scanner and milled using Delcam software on a DentMill...
DENTAL TEAM: Ken Upright, Oxford Crown & Bridge, LLC and Dr. Shelley Olson, DDS, FICD, Granville Family Dentistry, both in Oxford, NC
RESTORATIVE PROBLEM: A female patient fractured the entire facial surface and buccal cusp of tooth #4, which had an old MOD amalgam restoration. Due to a 2mm diastema, the entire mesial aspect of the crown would be exposed in the patient's smile, so shade quality was a foremost concern.
TREATMENT PLAN: Because of her positive experiences with the material, Dr. Olson prescribed a Delta Zirconia full contour crown to restore tooth #4. High Translucent Delta Zirconia,...
DENTAL TEAM: Gyu Cho, CDT, 3D BioCAD Milling Center, Renton, WA and Dr. Ronald Bryant, Seattle
RESTORATIVE PROBLEM: The patient presented with severe occlusal wear on his natural teeth; the lower anterior teeth were also very crooked and discolored. The existing crowns also exhibited wear, tissue retraction, dark margins and uneven shades from one crown to the next. Teeth #5, #12 and #14 were missing, requiring implants.
TREATMENT PLAN: A full-mouth restoration with 28 units was proposed and had full compliance from the patient. The team opted to use gold-hue abutments to provide a very natural,...
DENTAL TEAM: Cindy Vuong and Dr. Michael DiTolla, both of Glidewell Laboratories, Newport Beach, CA
RESTORATIVE PROBLEM: The patient presented with a pre-existing discolored PFM restoration on tooth #8.
TREATMENT PLAN: Dr. DiTolla prescribed a full contour BruxZir® crown, and decided to take the opportunity to test the translucency of Glidewell Laboratories' new BruxZir™ Shaded material, which offers complete color penetration all the way through the restoration for greater shade consistency. The new material also prevents shade changes or white "show-through" after occlusal adjustment....
DENTAL TEAM: Manfred Pörnbacher and Clemens Schwerin, Dentallabor Steger, Brunico, Italy and Dr. Lyndon Cooper, Professor and Chair at the University of North Carolina, School of Dentistry, Department of Prosthodontics
RESTORATIVE PROBLEM: A young female patient lost teeth #7 through #14 in a car accident and was already wearing a provisional restoration that had resulted in pronounced jawbone atrophy.
TREATMENT PLAN: The team opted for a fixed superstructure supported by six implants at sites #7 and #8 and #11 through #14. Due to inadequate bone structure, the restoration would be an occlusally...
DENTAL TEAM: Dr. William Roddy and in-house technician Steve Coles, Flow Laboratory, Fort Worth, TX
RESTORATIVE PROBLEM: A 62-year-old female presented with implants on teeth #3, #4 and #5 and a PFM bridge placed by another dentist. The implants had been placed too far buccally and the patient was unhappy with the esthetics and thickness of the bridge. The patient's occlusal planes were also uneven, and she had another large-span anterior bridge on teeth #6 through #11 that was starting to show signs of decay at the margins.
TREATMENT PLAN: The team opted to remove both bridges and the remaining...
DENTAL TEAM: Scott Gallacher, Precision Milling Center, West Valley City, UT, and Steven Barker, DDS, Salt Lake City, UT
RESTORATIVE PROBLEM: The patient was missing a second bicuspid (#12), didn't want an implant crown and was also concerned about the reduction of the adjacent healthy teeth.
TREATMENT PLAN: To address the patient's desire for the most minimally invasive solution, the team opted for a full contour bridge with minimal retention, using ORIGIN LIVE Plus zirconia since the case required both high strength (for minimal enamel removal) and high translucency (for full contour). Dr. Barker...