Long term Mock-Up: a New Option

Ortho and Kids - Direct anteriors
3 Nov 2015

Every day patients ask for esthetic treatment and more and more often they want to improve their esthetic in a short time. But there are situation in which it’s impossible to restore function and esthetic without going truth an orthodontic treatment, in order to give the prosthodontic or restorative clinicians the best way obtain the best results. However, at the end of ortho, the prosthetic treatment must be delayed for 6-12 months, waiting for the occlusion adjustment and recovery. During this time, it’s mandatory to stabilize the results providing provisional restorations. In this fields, EGR (Esthetic Guided Restorations) can be widely and conveniently employed. They allow to maintain stable occlusion combined with good esthetic in front teeth. The shell of EGR are totally prepolimerized with an high conversion degree. This mean more stability during time in abrasion, color, mechanical properties etc.

Fig. 1

In 2012 became at our observation P.B., aged 53, presenting a Class III malocclusion with negative overjet and multiple abfraction and abrasion. The orthodontic treatment, lasted 22 months, involved upper incisors proclination, lower incisors stripping and torque control and Class III mechanics using intermaxillary elastics.(Fig. 1 and 2).

Fig. 2
Fig. 3

The same day of the debonding, the upper incisors were restored. No surface prep was performed, only a surface sandblasting with aluminum oxide.

Fig. 4

After rubber dam isolation, 4 componeer (size Large, Value Universal) were relined using composite. In order to simplify the luting stage, the EGR have been applied one by one and the cervical limit determinate by a 9T clamp. Finishing and pre polishing were performed using burs, discs inter proximal strips and EVA handpiece (Fig. 3, 4, 5, 6).

Fig. 5
Fig. 6

One week later adjustment of form and size were made, as well as final polishing and surface texture.

Fig. 7

New smile

Fig. 8

In Fig.8 pre and post EGR smile display: notable improvement of esthetic was obtain only in 1 appointment . One year follow up in Fig. 9 show the maintenance and stability of the restoration in shape, color, marginal adaptation and texture. At this time,as the occlusion is stable, the patient may begin the prosthetic treatment with porcelain veneers.

 

Bibliography