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42 | CERECDOCTORS.COM | QUARTER 2 | 2014
VITA ENAMIC was the suggested
approach to treatment.
This suggested treatment was
initially met with skepticism as VITA
ENAMIC was still new and dentists
were not yet familiar with the material.
A number of convincing facts helped
change the dentist’s mind
and the green light was
given to proceed with the
treatment plan.
Fig. 1: 18-year-old patient with
agenesis of the upper lateral incisors
Fig. 2a: Conventional silicate ceramics
do not offer integrated crack
prevention
Fig. 2b: The VITA ENAMIC composite
(a combination of ceramic and
polymer material) offers integrated
crack prevention
(Source: VITA R&D, Vickers indentation)
Fig. 3: Initial situation
Cosmetic CAD/CAM Restoration
Utilizing VITA ENAMIC
Reshaping Canines to Create Lateral Incisors
C A S E S T U D Y | | | B Y VA N I K K A U F M A N N - J I N O I A N , M . D . T.
DECISION-MAKING PROCESS
The patient was met by chance in
December 2012 during a visit to a local
dentist, where the suggested approach to
treatmentwasinitiallymetwithskepticism.
The VITA ENAMIC composite material
was still completely new at the time, and
the dentist hadnot heard of it. Anumber of
facts helped to change the dentist’s mind.
For starters, the hybrid ceramic combines
the benefits of dental ceramics with those
of compositematerials. By combining both
materials, VITA ENAMIC offers both
stability and elasticity, enabling thinner
walls forminimally-invasive restorations.
The reliability of the material is also
supported by integrated crack preven-
tion (Figs. 2a-2b). In addition, the mate-
rial offers excellent edge stability after
milling. This is generally a benefit in
itself, but is also crucial in a case such as
this in order to create thin restoration
margins that taper off smoothly.
The tooth-colored material facili-
tates light transmission with a natural
appearance. In this way, VITA ENAMIC
restorations can be integrated perfectly
into the remaining tooth substance,
providing an attractive play of colors.
CASE PRESENTATION
Second only to missing wisdom
teeth, agenesis of the upper lateral
incisors (#7 (#12) and #10 (#22)) is
the most common cause of congen-
ital hypodontia (i.e., unrelated to
an accident). For a young person in
particular, this anomaly can have an enor-
mous impact on self-confidence. Reshaping
the canines to create lateral incisors seemed
anappropriate courseof action.
However, given that the tooth substance
was healthy, an approach to restoration
was required thatwas as gentle as possible
onthesubstance.Partial,non-prepveneers
fabricated using the CAD/CAM restora-
tionmaterial VITAENAMICproved to be
particularly suitable in this case.
what started as a chance meeting
in a dentist’s office turned into a chal-
lenging restorative case using the new
VITA ENAMIC (VITA Zahnfabrik, Bad
Säckingen, Germany) hybrid ceramic
material. The 18-year-old patient
presented with agenesis of the upper
lateral incisors (Fig. 1). Reshaping the
canines to create lateral incisors seemed
an appropriate course of action. Partial,
non-prep veneers fabricated using the
new CAD/CAM restoration material
1
2a
3
2b