Dental Asia July/August 2022

More documents

Recommendations

Info

USER REPORT Digital aesthetic smile reconstruction A digital protocol was adopted for an eight-unit ceramic restoration utilising 3Shape clinical and laboratory workflows as Dr Naren Rajan elaborates more. The patient was a 53-year-old female in good overall health with a non-contributory medical history. She wanted to have a natural-looking upgrade to her teeth without the result of looking too white and was not interested in treating the lower teeth. Fig. 1 Fig. 2 Upon clinical examination, the patient presented with an edgeto-edge bite with asymmetric wear on the upper anterior as well as two existing laminates on the upper right cuspid and lateral. The treatment plan included a referral for pre-prosthetic orthodontic therapy followed by restoration of the upper eight anterior teeth with layered ceramic restorations. The intended outcome was to restore symmetry, form, function and aesthetics to the patient’s smile without significantly altering her overall appearance. TREATMENT The patient was first referred to the orthodontist to address her edge-to-edge occlusion prior to any restorative treatment. The goals of orthodontic treatment Fig. 3 Figs. 1-2: Post ortho presentation Fig. 3: TRIOS Smile Design – proposed outcome Fig. 4: Dental System digital waxup were to level the gingival margins, align the teeth and to re-establish correct overjet and overbite. We utilised TRIOS Smile Design at the time of orthodontic referral to communicate our treatment goals to the orthodontist as well as share our vision of the potential results with the patient. When orthodontic treatment was completed, the patient returned for updated records that included new photography and postorthodontic TRIOS scans (Visit 1). Fig. 4 The TRIOS scans were brought into Dental System and a digital waxup was created using the Temp on Prepared Model workflow. The digital waxup was output as a stereolithography (STL) model and printed using a desktop 3D printer. A Dental Desktop order was created for crowns on teeth 14, 13, 12, 22, 23 and 24, and veneers on teeth 11 and 21. The Pre-Preparation scan was enabled. On the day of preparation (Visit 2), a putty matrix was made and used to create a biscaryl intraoral 42 DENTAL ASIA JULY / AUGUST 2022
USER REPORT mockup prior to beginning tooth preparations. While waiting for anaesthesia, we scanned the upper arch with a mockup applied as a Pre-Preparation, the lower opposing arch and two-bite registrations. After marking the teeth as directed, we carefully trimmed away the clinical crowns of the teeth being treated to maintain as many attached tissues to allow for easily scannable areas while capturing the preparations. Fig. 5 The initial depth cuts were made directly through the bisacryl mockup to ensure conservative tooth reduction in additive design areas. After the preparations were completed and refined, we placed dual retraction cords and allowed them to remain in place for 10-15 minutes. The top cord was then removed and all eight preparations were scanned to complete the necessary records. The case was post-processed and evaluated to ensure all areas were adequately recorded. Fig. 6a Fig. 6b Fig. 6c Fig. 7a Fig. 7b Provisional restorations were fabricated with a bisacryl shrink wrap technique using the same putty matrix from the mockup. The provisionals were trimmed and polished, and the patient was dismissed. Fig. 7c Fig. 5: Bisacryl mockup applied before preparation Figs. 6a-6c: Preparation Figs. 7a-d: Final outcome Fig. 7d We saw the patient after a week from post-op (Visit 3) at which time we evaluated the provisionals and made minor occlusal adjustments in excursions. Once both the patient and clinician were satisfied, we obtained a TRIOS scan of the provisionals. It was only at this time that we instructed the laboratory to proceed with manufacturing the final restorations copied as close as possible to the approved provisionals. Approximately three weeks later, the patient returned for her delivery visit (Visit 4). The provisionals were removed and the restorations were tried in. The restorations required only one minor contact adjustment between teeth 22 and 23 where we felt the contact was slightly tight. Otherwise, the units fit impeccably well and satisfied the patient’s initial treatment goals. The units were isolated and bonded with resin cement and the patient was seen another week later for a post insertion visit (Visit 5) where we checked the occlusion and took postoperative photographs. A posttreatment TRIOS scan was also taken in centric relation (CR) to be used for the fabrication of an occlusal guard. DIGITAL ECOSYSTEM The long-term benefit of using 3Shape digital workflows is being able to implement and grow digital skills over time at your own pace. Being a TRIOS user DENTAL ASIA JULY / AUGUST 2022 43
Page 1: www.dentalasia.net JULY / AUGUST 20
Page 5 and 6: Dental Updates Whatever tomorrow ho
Page 8 and 9: DENTAL UPDATES Envista to acquire O
Page 10 and 11: DENTAL UPDATES exocad Asia moves to
Page 12 and 13: DENTAL UPDATES Oral-B and Straumann
Page 14 and 15: DENTAL UPDATES Medit and Panthera r
Page 16 and 17: DENTAL UPDATES Septodont releases n
Page 18 and 19: TRENDS Connecting patients closer t
Page 20 and 21: TRENDS NSK harnesses green power Sw
Page 22 and 23: DENTAL PROFILE ZimVie opens doors t
Page 24 and 25: DENTAL PROFILE In your opinion, how
Page 26 and 27: DENTAL PROFILE Embarking on the dig
Page 28 and 29: CLINICAL FEATURE Immediate implant
Page 30 and 31: CLINICAL FEATURE granules distant f
Page 32 and 33: CLINICAL FEATURE Orthodontic space
Page 34 and 35: CLINICAL FEATURE Fig. 9a Fig. 9b Fi
Page 36 and 37: CLINICAL FEATURE Growing intimate w
Page 38 and 39: CLINICAL FEATURE tooth surfaces of
Page 40 and 41: CLINICAL FEATURE instructed to wear
Page 42 and 43: USER REPORT Centripetal layered bui
Page 46 and 47: USER REPORT since 2015, I began by
Page 48 and 49: USER REPORT Same-day visit implant
Page 50 and 51: BEHIND THE SCENES Bringing 3D print
Page 52 and 53: BEHIND THE SCENES Digital denture -
Page 54 and 55: BEHIND THE SCENES The bridge betwee
Page 56 and 57: IN DEPTH WITH Practice transformati
Page 58 and 59: PRODUCT HIGHLIGHTS Mectron Next-gen
Page 60 and 61: PRODUCT HIGHLIGHTS VITA The system
Page 62 and 63: PRODUCT HIGHLIGHTS Neoss Scan with
Page 64 and 65: PRODUCT HIGHLIGHTS BUSCH Filigree a
Page 66 and 67: SHOW PREVIEW Dentsply Sirona announ
Page 68 and 69: GIVING BACK TO SOCIETY FDI and Toot
Page 70 and 71: ADVERTISERS’ INDEX COMPANY PAGE 3
Page 72: Only makes it happen Digital soluti

Dental Asia July/August 2022

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?