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QUARTER 4 | 2014 | CERECDOCTORS.COM | 51
thin the restoration is. With any other
CAD/CAM ceramic, significant chipping
at the edgeswould be the expected result.
THIN VENEERS
ON DISCOLORED DENTITION
Tooth #9 (21), which had previously
undergone root canal treatment,
showed considerable discoloration
(Figs. 4a-4b). In such cases, the tooth
is often remodeled using a screw at its
core, and restored using an all-ceramic
crown. As the hybrid ceramic VITA
Enamic allows very thin layers to be
used, this effort is no longer neces-
sarily required. However, the unat-
tractive color of the stump does hinder
an esthetic result. If there are issues
of this kind with regard to shading,
one possible solution is to adopt an
Fig. 3a: Agenesis of the lateral incisors
Fig. 3b: Canines remodeled to match the
shape of lateral incisors
Fig. 4a: Tooth #9 (21), which has
undergone endodontic therapy,
with a dark, unesthetic appearance
Fig. 4b: Minimally invasive preparation
Fig. 4c: Experimental approach:
application of a bright monomer
layer for the purposes of masking
Fig. 4d: Good shade match between
tooth #8 (11) and tooth #9 (21)
approach used by the dental techni-
cian: if a dental technician anchors a
restoration on a titanium abutment that
is black in appearance, for example, it
goes without saying that an opaquer
will be used.
When using veneers and crowns in
the all-ceramic CAD/CAM treatment
of teeth that require restoration, dental
surgeons are often faced with similar
difficulties in the shape of discolored
tooth stumps. Figure 4c shows the discol-
ored tooth stump #9 (21) after it has been
masked with a layer of bright opaquer as
part of conditioning for adhesive cemen-
tation. The VITA Enamic restoration
was then fitted as usual, matching well in
terms of shade with the adjacent tooth as
a result (Fig. 4d).
SUMMARY
WhileconventionalCAD/CAMceramics
thinner than < 1.0 mm are likely to chip
and fracture, VITA Enamic usually
allows this to be achieved without any
difficulty. However, with thin recon-
structions of this kind, the underlying
structure is likely to show. The use of
opaquer materials is unlikely to create a
natural-looking result. The tooth stump
and restorationmaterial must be consid-
ered together as one system in terms of
shade effect. The solution is to apply
opaquer to the dark tooth stump during
conditioning for adhesive bonding.
This approach is not officially recom-
mended by the manufacturer; however
we have used it over the last four years
in our practice without any difficulty
and without any loss of retention.
For questions and more information,
Dr. Baltzer can be reached at
andres@baltzer.ch.
While conventional
CAD/CAM ceramics
thinner than < 1.0 mm
are likely to chip and
fracture, VITA Enamic
usually allows this to
be achieved without
any difficulty.
3a 4a
3b 4b
4c
4d