CATEGORY 92 AUSTRALASIAN DENTIST CLINICAL Ultimately, the patient must live with the consequences of the chosen treatment, and our responsibility as dental professionals is to preserve as much natural tooth structure as possible. The ability to provide such conservative solutions – in this case, through the refractory feldspathic veneer technique – requires years of technical training, precision and an uncompromising eye for detail. Model fabrication: contouring, staining, glazing, polishing and divesting. Each stage builds upon the last, requiring patience, technical accuracy and an uncompromising eye for aesthetics. The result balances minimal intervention with precise colour control and natural vitality. Fig. 44 shows the restoration during clinical try-in, while Fig. 45 demonstrates the veneer seated with a neutral try-in paste. The use of try-in paste is particularly important with thin refractory veneers, as it allows accurate chairside evaluation of colour, value and integration with the surrounding dentition. Without this step, subtle discrepancies may be overlooked and become apparent only after bonding. In this case, no colour adjustment was required. The veneer harmonised with the adjacent teeth, confirming that the restoration was ready to be issued. Post-op and outcome Figure 38: Solid model for contact point assessment. Figure 42: Completed restoration seated on the solid model after sandblasting. Figure 46: Immediate postoperative result. Figure 40: Degassing of the refractory die. Figure 44: Clinical try-in. Figure 48: Postoperative smile at rest. Figure 39: Working model with a removable single die. Figure 43: Completed refractory veneer. Figure 47: Two-week postoperative follow-up. Figure 41: Working model with removable refractory die. Figure 45: Restoration seated with a try-in paste. Figure 49: Postoperative smile. The fabrication of the refractory model is one of the most technically sensitive and time-consuming aspects of this technique. Precision at this stage is critical, as the quality of the refractory die directly influences the accuracy and fit of the final restoration. Unlike CAD/CAM workflows, where accuracy can be verified and adjusted digitally, the refractory method relies entirely on manual craftsmanship, leaving little margin for error. Several meticulous steps are required to complete the model, each demanding care and attention to detail. Any compromise during pouring, trimming or surface conditioning can translate into inaccuracies in the final restoration. Recent advances in digital technology have simplified this process to some extent. Digital impressions and printed models allow a cone-shaped removable die to be fabricated digitally and accurately embedded within the working model. A die spacer is then applied, terminating approximately 1 mm short of the preparation margin, before the die is duplicated in refractory material. This hybrid workflow reduces some of the model-production complexity while preserving the manual ceramic layering central to the refractory technique. The consistency of the workflow can be appreciated across the different model types, each serving a specific purpose. The solid model (Fig. 38) is used to verify proximal contacts and occlusion after the veneer has been completed. The master working model with the original dental stone die (Fig. 39) allows verification of the marginal integrity and internal fit of the final veneer. Fig. 40 shows the degassing of the completed refractory die before ceramic buildup, while the refractory die seated within the working model (Fig. 41) provides the platform for ceramic layering and fabrication. Each model plays a distinct role while remaining consistent with the others, reinforcing accuracy throughout the workflow. With this foundation established, the case is ready to progress to ceramic layering. Final Restorations and Clinical Try-in: Figure 42 shows the completed refractory veneer seated on the solid model after sandblasting, while Figure 43 presents the restoration individually. The restoration represents the culmination of a long and detailed process involving refractory die fabrication, ceramic layering, Fig. 46 shows the completed restoration immediately after bonding. The outcome was well received by both the patient and treating clinician, confirming that the aesthetic and functional objectives had been achieved. At the two-week postoperative review (Fig. 47), the veneer integrated seamlessly with the surrounding natural dentition. Its surface lustre, optical depth and colour harmony demonstrated the precision achievable through the refractory veneer workflow. Figs. 48 and 49 show the postoperative result both at rest and in a close-up smile, concluding the case journey. The objective of this case was clear: to create a restoration that would remain undetectable within the smile. This was achieved while preserving the natural tooth structure, demonstrating that
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