37
significant root resorption, and needed to be extracted. An imme-
diate implant was placed. Tooth #8 was also restored to satisfy a
visual width discrepancy between the two central incisors.
The versatility that e.max shows in this case is in the complexity
of two different types of restorations: tooth #9 is an abutment-
supported implant crown, and tooth #8 was conservatively
prepared for a thin porcelain veneer (Fig. 16). The key to this is
that the shape and color of the final zirconia custom abutment
was designed with the intent to not only recreate the emergence
profile of the natural tooth, but also recreate the dentin such that
the labial thickness of both the implant crown and the thin veneer
would be the same (0.3 mm-0.5 mm). Both restorations were
milled in an e.max high-translucency BL2 ingot.
Due to the material’s enamel-like characteristics, natural-
looking restorations can be designed chairside using e.max CAD
for a variety of adjacent restorations; as long as the clinician
respects its attribute as a monolith. Teeth are not monolithic, but
enamel is. Monolithic lithium disilicate, especially a higher-trans-
lucency ingot, makes an excellent monolithic enamel replacement.
However, if the thickness of the restoration requires the replica-
tion of both enamel and dentin, then the underlying build-up — or
the abutment in this case — must be designed in thickness, color
and shape in order to correctly replace the dentin anatomically.
This then allows the ceramic to be the same appropriate thickness
of an anatomic enamel replacement and, as such, provides similar
optical properties that can give a restoration a natural look, and
thus harmonizing with the surrounding dentition (Fig. 17).
When an anterior case presents with restorative needs that
involve a combination of differing indirect restoration types (i.e.
veneers, implant crowns or even bridges alongside natural teeth),
the versatility of e.max can offer the clinician confidence that the
material, when managed appropriately, will have the ability to
endure, blend-in and predictably look beautiful in spite of the chal-
lenges that a combination case may pose.
Fig. 14: Pre-treatment smile view
Fig. 15: Post-treatment smile view
Fig. 16: Dentin shade selection
Fig. 17: e.max veneer #8, e.max abutment crown #9
