relined with Telio CS Crown & Bridge and cemented with Telio
Link (Ivoclar/Vivadent).
Both e.max CADFPDs weremilled in A2LT shade and proximal
and occlusal contacts were adjusted using a PVS fit check material
as a cushioning layer (Fit Checker, GC). Restoration processing
followed the steps previously described, paying special attention
to surface texturizing. The uniqueness of this case relies on the
challenge of properly matching the shade and appearance of the
restorations with the existing dentition. The pattern of applica-
tion of the IPS e.max CAD stains and shades mimicked pre-oper-
ative photographs of the un-prepared teeth and was achieved by
using White and Cream stains on the textured lithium disilicate
surfaces. The stains were used both concentrated and as a wash
(mixed with Crystall Glaze to achieve lower chromatic effect) to
ultimately attain a 3-D color effect. Also, shade Incisal 2 was spar-
ingly used on the incisal third to create an illusion of translucency,
and Copper was selected to replicate the darker discolorations. All
stain and glaze was completed over the un-crystallized lithium
disilicate surface and final effect was achieved in a single firing
for each framework. Lastly, the FPDs were polished with e.max
polishers to achieve a more natural surface gloss. The restorations
were cemented with Multilink Automix self-curing resin cement.
This clinical case illustrates the level of customization that can
be achieved by dentists in fabricating chairside CAD/CAM resto-
rations. Mastering every step of the manufacturing process and
being able to deliver restorations with precision fit and unsur-
passed esthetics amount to an extremely rewarding experience to
the doctor. It is exceptionally liberating to be able to prevent all
frustrations that are common between patient-laboratory commu-
nications. Therefore, chairside CAD/CAM restoration fabrication
combinedwith porcelain characterization assure that the dentist’s
vision can be matched through maximum technique control and
unparalleled artistry for the patient’s ultimate benefit.
For questions and more information, Dr. Neiva can be reached at
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