Anterior Restoration Utilizing Novel All-Ceramic Materials

Thomas F. Trinkner, DDS

Learning Objectives:  

After reviewing this case study, the reader should:

• Be able to visualize the process of creating anterior restorations using all ceramic material
• See the excellent aesthetic results that all ceramic restorations can provide patients

In order to provide the highest level of patient care, the restorative team must be able to deliver treatment that is not only biocompatible and functional but also predictably aesthetic. As the field of aesthetic dentistry has continued to expand, this indicates that the final restorations must have a natural appearance and be harmoniously integrated with proper soft tissue architecture that has been gently and meticulously controlled throughout the duration of the restorative procedure. Consequently, the importance of the provisionalization phase as a means to evaluate aesthetics, phonetics, and function cannot be underestimated. At this phase, any necessary adjustments can be performed prior to the fabrication and delivery of the definitive restorations. The selection of an appropriate restorative modality that achieves the patient's expectations depends on the patient's inherent condition, the physical properties of the involved materials, the skills of the clinician and laboratory technician, and the communication between these dental professionals. Data transfer between the practice and the laboratory is facilitated by various means that include radiographs, photographs, diagnostic waxups, articulator-   mounted models, and the provisional restorations. The eventual success of the restorative procedure is directly related to the dynamic and evolving relationship of these dental professionals.

A 19-year-old male patient presented with maxillary lateral incisors that exhibited insufficient crown height, which resulted in diastemata and aesthetic compromise. Wear patterns were evident on the cuspids, particularly when they were manipulated into lateral guidance. Comprehensive radiographic and clinical examinations were performed; these analyses indicated that the soft tissue levels and symmetry of the patient were adequate and did not require osseous surgical augmentation. Following a thorough evaluation of the temporomandibular joint and its musculature, it was determined that the joint was noncontributory to the patient’s condition. No pain was present upon mastication, and the patient’s medical history was not relevant. The patient requested aesthetic enhancement in order to correct the form and appearance of the existing dentition.

*Private practice, Columbia, South Carolina