GAP Australasian-Dentist-Mar Apr 2019

Category 76 AustrAlAsiAn Dentist subgingival contours, which support the oral soft tissue, so that the restorations would not have to be individually adjusted in the dental office. the crowns were milled from a dimensionally stable wax disc. ProArt CAD Wax yellow was used in the present case (Figs 9 and 10). this material is specially designed for use with iPs e.max Press. the smooth surfaces of the wax ensure precision results and high accuracy of fit. the material burns out without leaving any residue. up to this point, it was possible to reduce the manual work to a minimum. Spruing and pressing in the next step, the wax crowns were reproduced with a pressed ceramic (iPs e.max Press Multi). For the investment procedure, the milled wax crowns were attached to a special prefabricated precision wax component (iPs Multi Wax Pattern). At this stage, it is important to make sure that the attachment joint is not too thick and that it is aligned with the labial surface. this helps to accentuate the unique shade gradations of the material. the wax restoration attached to theWax Pattern was subsequently secured in the slot of the iPs Multi investment ring base. the position of the sprues was checked with the help of the iPs sprue Guide (Fig. 11). the shade progression within the crown can be adjusted as required. For example, if the incisal portion should be more pronounced, the Wax Pattern is simply moved downward on the investment ring base (max. 2 mm). the preheating, pressing and divestment steps were carried in the customary way and in line with the instructions of the manufacturer. Finishing the pressed restorations can be adjusted if desired in order to accentuate certain individual characteristics. in the present case, the unglazed restorations were tried in the patient’s mouth before the stains and glaze firing. At this stage, most of the clinically important properties were clearly recognizable: tooth axes, suitable pressure on the adjacent soft tissue (e.g. papillae and gingival contour), harmony of the lip line and incisal edges as well as the symmetry of the crowns. the patient was satisfied with the optimized length- to-width ratio of the teeth. the main aim now was to reproduce this situation with utmost precision. the inter-occlusal record was sent to the laboratory in order to minimize the work involved in the adjustment of the occlusion. the surface texture of the iPs e.max Press Multi crowns was created with suitable grinding instruments before the glaze firing cycle. the restorations were then characterizedwith iPs ivocolor ® stains (copper, white and anthracite) and glazed. the crowns were manually polished to the desired brilliant sheen (Fig. 12). Placement the excellent collaboration of the dentist, dental technician and the patient paid off: the restoration was swiftly placed in the practice without having to make any further adjustments. the clinical situation which was created on the model and with thehelpof provisional restorations couldbe successfully reproduced in the permanent restoration (Fig. 13). the patient and the dental team were highly satisfied with the result. the entire treatment process was straightforward and efficient. Result One month later, the teeth and gums looked beautiful and healthy without any inflammation. Digital workflows minimize efforts but maximize esthetics. the possibility of replicating the subgingival contours of the provisional crowns allowed a variety of modifications to be made during the treatment process. the iPs e.max Press Multi material itself offers an impressive array of esthetic properties. if a restoration requires even more individualized characteristics, the incisal area can be built up with iPs e.max Ceram layering materials (cut- back technique). the presented process shows that the traditional press technique combined with CAD/CAMmethods offers a wide variety of benefits and provides a basis for new and innovative applications. the discovery of further creative uses involving a combination of these two techniques is only a question of time. u Heal Dental Clinic 309, Gangseo hillstate shopping center 242, Gangseo-ro, Gangseo-gu Seoul, South Korea healdentalclinic@gmail.com Figure 6: Scanned data of the final preparation Figure 7: Superimposed scanned data of the prepared model and the model with the provisional crowns Figure 8: Slight adjustments during the design phase Figure 9: ProArt CAD Wax yellow disc full-contour wax crowns Figure 10: CAD/CAM-manufactured Figure 11: Full-contour wax crowns attached to the IPS Multi investment ring base and verification of the position of the wax crowns with the help of the IPS Sprue Guide Figure 12: Completed crowns on the model Figure 13: IPS e.max Press Multi restorations immediately after placement lInICal