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Figure 7
Figure 8
Figure 7: This occlusal view is imperative when deciding what type
of veneers to place on a patient. Dentists frequently send me smile
pictures and ask if the patient needs no-prep or minimal-prep veneers,
but you can’t have that discussion without an occlusal picture.
In this case, tooth 10 is an excellent candidate for a no-prep
veneer.
Figure 8: A close-up look at the zirconia-based crown on tooth 9
shows that the incisal edge is longer than tooth 8, and the overall
shape of the crown does not match 8 either. We decided to use an
all-ceramic crown without a substructure to replace the zirconia
crown, in hopes of getting a better match. I opted to use an IPS
e.max CAD LT crown.
Figure 9
Figure 10
Figure 9: I still give the patient some local anesthesia since I will be
placing two retraction cords. I used to try to avoid local anesthesia
when possible, but since developing a painless injection technique,
it is not an issue. Here I place Profound Lite (Steven’s Pharmacy,
Costa Mesa, CA) topical anesthetic for 45 seconds and then rinse
it off.
Figure 10: After the Profound Lite has been rinsed off, I use the
STA System (Milestone Scientific, Livingstone, NJ) to deliver the
Septocaine ® (Septodont, New Castle, DE) on the slowest speed. After
about 20 seconds, I switch the STA System to the normal speed,
as the patient is already anesthetized in that area. This is the easiest
way to give a painless injection.
Photo Essay: IPS e.max CAD LT Case Study19