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Case Study
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Predictable Laboratory Sequence for Aesthetic Rehabilitation of Maxillary Central Incisors

Learning Objectives:

Upon reading the following case presentation, the reader should:

  • Understand how powders and pocelain shades can be used to develop proper shades for restorations.
  • Realize the importance of communication between the ceramist and clinician in a restorative case.

 

In fabricating a single tooth or single teeth in the esthetic zone, the ceramist faces numerous technical challenges. Achieving a proper shade match is paramount, whether the restorations mask varying substrates or the adjacent natural dentition, and natural light reflection and refraction are treatment imperatives. Careful treatment planning and disciplined laboratory protocols are essential to achieving an esthetic treatment outcome. This presentation documents a predictable laboratory fabrication sequence used to restore two central incisors to a natural esthetic result. 

When fabricating a single tooth or single teeth in the anterior maxilla, the ceramist must address numerous technical challenges. In addition to fit and a functional result, a proper shade match is paramount in this highly visible region, whether the restorations mask substrates of varying color or the adjacent natural dentition, and natural light dynamics (eg, absorption, reflection, refraction) are treatment imperatives. Careful treatment planning and communication among the clinician and ceramist and should be combined with disciplined laboratory protocols in order to achieve an esthetic treatment outcome. As shown in the following presentation, contemporary ceramic materials--with a range of effect powders and porcelain shades--enable the laboratory technician to develop restorations that are virtually indistinguishable from the natural dentition. 

In order to produce natural, highly esthetic restorations, the dental technician must master the art of shade matching and the nuances of a porcelain buildup. The maxillary incisors represent the focal point of a person’s smile. It is, therefore, important for the dental technician to consider the effect each ceramic layer will have on the appearance of the final restorations placed in these areas. 

 

*Laboratory Technician, Idaho Falls, Idaho

  

Related Reading:

  1. Bindo TZ, de Morais EC, de Campos EA, Gonzaga CC, Correr GM, Baratto-Filho F. Multidisciplinary approach of a crown-root fracture using intentional replantation: a case report. Pediatr Dent. 2010 Sep-Oct;32(5):428-32.
  2. Rajput A, Ataide I, Lambor R, Monteiro J, Tar M, Wadhawan N. In vitro study comparing fracture strength recovery of teeth restored with three esthetic bonding materials using different techniques. Eur J Esthet Dent. 2010 Winter;5(4):398-411.
  3. Ardu S, Stavridakis M, Feilzer AJ, Krejci I, Lefever D, Dietschi D. Marginal Adaptation of Large Adhesive Class IV Composite Restorations Before and After Artificial Aging. J Adhes Dent. 2010 Sep 28. doi: 10.3290/j.jad.a19649.
  4. Nothdurft FP, Doppler KE, Erdelt KJ, Knauber AW, Pospiech PR. Influence of artificial aging on the load-bearing capability of straight or angulated zirconia abutments in implant/tooth-supported fixed partial dentures. Int J Oral Maxillofac Implants. 2010 Sep-Oct;25(5):991-8.
  5. Bhargava M, Pandit IK, Srivastava N, Gugnani N, Gupta M. An evaluation of various materials and tooth preparation designs used for reattachment of fractured incisors. Dent Traumatol. 2010 Oct;26(5):317-20. doi: 10.1111/j.1600-9657.2010.00913.x.
  6. Schwengber GF, Cardoso M, Vieira Rde S. Bonding of fractured permanent central incisor crown following radiographic localization of the tooth fragment in the lower lip: a case report. Dent Traumatol. 2010 Oct;26(5):342-5. doi: 10.1111/j.1600-9657.2010.00908.x.
  7. Garbin CA, Spazzin AO, Meira-Júnior AD, Loretto SC, Lyra AM, Braz R. Biomechanical behaviour of a fractured maxillary incisor restored with direct composite resin only or with different post systems. Int Endod J. 2010 Dec;43(12):1098-107. doi: 10.1111/j.1365-2591.2010.01782.x.
  8. Nissan J, Mardinger O, Strauss M, Peleg M, Sacco R, Chaushu G. Implant-supported restoration of congenitally missing teeth using cancellous bone block-allografts. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jul 29.
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