RESTORATIVE CHALLENGE: The 34-year-old female patient wanted to improve the esthetics of her teeth which were compromised by a large filling in tooth #8 and severe discoloration on tooth #9 caused by trauma and improper restoration following a root canal (see Figure 1). The patient wanted the restorations within a week but also wanted the best esthetics available.
Restorative team: Vladimiro Obinu, CDT, and Dr. Domenico Dentici, both from Genova, Italy
Treatment plan: After making a diagnostic waxup, the team opted for a pressed veneer on #8 and a layered full porcelain crown on #9, both made with the Cerpress SL Pressable Ceramic System from Leach and Dillon Products (see Figure 2). The team chose Cerpress SL because of its lifelike qualities, natural translucency and brilliant fluorescence. The pressing ingots are offered in various levels of opacity for challenging situations.
Case study: Vladimiro Obinu developed both a master model and a working model; the soft tissue was eliminated on the working model for more accurate fabrication of the restorations. He made a diagnostic waxup for the crown and veneer using the master model to determine final shape and contour. After finishing the margins and following the parameters required for pressing, he invested and pressed. On the crown, he had to cover the dark discoloration so he used a high opacity pellet, "HO1." For the veneer, he used a medium opacity pellet, "MA1."
Using a microscope, Obinu adapted the porcelain to the master model and started to shape the crown and give some superficial texture to the veneer. Next, he layered the crown using Sensation SL porcelain, keeping in mind the shape and thickness parameters dictated by the waxup (see Figure 3). Next, with the patient in the laboratory, he characterized the restorations using Sensation SL Fluorescent Stains.
Dr. Dentici cemented both restorations with a transparent, medium-opacity, composite bonding cement (see Figures 4 and 5).
Contact Information: Leach and Dillon, 800-535-2633