Problem: Chipped, cracked, or worn teeth

Treatment Options:
Teeth that are chipped, cracked, or worn can be perfectly restored with ultra-thin, specially made laminates or veneers. Either option can close gaps or disguise discoloured teeth.

Long-lasting porcelain or composite veneers are ultra-thin, specially made laminates that are bonded to the teeth. Veneers are stronger and have a longer life than bonding, but the process requires more time.

Bonding is a process in which an enamel-like material is applied to a tooth's surface, sculpted to an ideal shape, hardened, and then polished for an ideal smile.

FRONTAL VIEW 1:2 Magnification Retracted Pre-Operative FRONTAL VIEW 1:2 Magnification Pre-Operative FRONTAL VIEW 1:2 Magnification Post-Operative

Preparation Design The Preparation design for this case was as follows: All ceramic crown preparation design was applied to teeth #2-15 with minimum to moderate reduction and rounded shoulder marginal finish line in order to accommodate IPS Eris restorations on teeth #2-6, 11-15 and IPS Empress Esthetic on teeth #7-10.    For the mandibular arch all ceramic crown preparation was applied to teeth #18-21,28-31 with moderate reduction and rounded shoulder marginal finish line to accommodate IPS Eris restorations. A laminate veneer preparation was applied to teeth #22-27. Porcelain Copings IPS Eris copings were pressed with 100 IPS Empress 2 Ingots. IPS Empress Esthetic Full contour Crowns were pressed with ETC1 Ingots.    The Laminate veneers were made utilizing a refractory die technique. A master model of the mandibular arch was fabricated, the dies were separated interproximally. Margins were trimmed and a die hardener was applied. Subsequently all of the dies were placed back into the impression and a pink tissue material was injected. A silicone mold of the master model was made and utilized to fabricate a refractory die master model duplicate. The dies were degassed prior to proceeding to the application of porcelain. Application Of Opaquers and Tints IPS Empress 2 Copings were stained internally to lower the value in the desired areas and enhance the appearance in order to create a natural looking dentition as well as to create the foundation layer for further layering of porcelains.    IPS Empress Esthetic Full contour crowns were trimmed back utilizing a lingual and labial putty matrix. Subsequently, a tint stains were applied to lay a foundation for naturally looking restorations.    For the refractory die technique a thin bonding layer of Vita 900 opaque dentine was applied and fired to create a nice uniform bed for layering of porcelains. A second layer of opaque dentine was then applied to mask any discolorations of the prepared tooth structure and fired once again. Application, Condensing and Sculpting of Porcelain IPS Eris Porcelain shade B2 was applied in the center of the occlusal surface to imitate the appearance of dentin. A pink and neutral mix of porcelains was used to lower the value around the gingival area. B1 Porcelain was used to build the buccal surface as well as some portion of the cusps. To finish the incisal build up layers of T-Blue, E-1 and E-3 were applied.    IPS Empress Esthetic Incisals Blue, Neutral and Opal Low Translucency were used to create a subtle effect that would meet this patient’s expectations and look naturally at the same time.    For the refractory die technique, a third layer of dentine porcelain was applied and build-up a little shy of the full contour of the desired size of restorations. That layer was also 0.2 mm short to the margins to provide room for translucent porcelain in order to achieve a lens effect blending with the natural tooth.

After firing, the porcelain was cut back utilizing a putty matrix of the wax up and to provide for internal effects such as mamelons. Internal stains were added to enhance subtle internal effects and then fired one more time. Incisal porcelains such as T5, T1 and Window porcelains were layered and slightly overbuild. After firing, the restorations were trimmed to the desired shape, the lateral and protrusive guidance were checked as well as uniform centric contacts. Last minimal addition porcelain was applied to compensate for additional corrections to and subsequently fired. Final Glaze After the final trimming was performed, external anatomy was applied and the restorations were fired with appropriate self natural glaze programs corresponding to each material. After the firing, the restorations were hand polished and high-shined with a cotton wheel and a diamond paste.

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