Fig.1
The chief complaint of the patient was her teeth were too big and the color was not pleasant.

Fig.2
The intra oral aspect of the 11, 21 zirconia oxide ceramic crowns showed, poor cervical adaptation of the crowns, inflammation of the gingiva, inadequate surface contact, high opacity of the restorations, no shape integration in the arch.

Fig.3
The crowns were removed and the composite restorations were replaced.

Fig.4
Two provisionals were fabricated chairside using the initial situation using Luxatemp composite. The shape was changed intra-orally with a direct mock-up according to the adjacent teeth.

Fig.5
The color for the final restoration was taken before taking the impression, before the dehydration of the teeth could occur.

Fig.6
After the healing of the gingiva the buccal margins were placed subgingivally because of the high chromatic color of the abutments. The final finishing of the abutments were made with Arkansas stone.

Fig.7
Finishing of the cervical area were made using the cord retraction in order to protect the epithelial insertion.

Fig.8
The final aspect of the preparation.

Fig.9
After the finishing of the margins, the second retraction cord was placed to displace the the marginal gingiva in the horizontal direction. The second cord should be completely visible after placement from incisal point of view.

Fig.10
The aspect of the gum after the removal of the second cord. The space for the impression material is clearly visible.

Fig.11
For this case I decided to use Honigum (DMG). The light body material is very flowable and will fill all the space made by the second cord.

Fig.12
The putty material is the most flowable material I ever used of its category. Thanks to the Snap-Set technology developed by DMG, the new Honigum-Putty offers a so far unrivaled combination of comfortable working time and short setting time inside mouth. Its generous working time reduces the mixing stress to a minimum. Deformations due to already set material are prevented, and micro movements are reduced by the quicker cross linking. For the patient, the shorter setting time translates into significantly higher comfort during the procedure.

Fig.13
Other advantages of this material are:
• Exceptional detail reproduction
• Outstanding stability in the tray and intraorally
• Remarkable flow properties under light pressure
• Balanced hydrophilicity
• Neutral taste and honey scent
A very good impression of the sulcus were obtained using one step wash technique.

Fig.14
After impression, the color of the abutment was taken using natural die material color (ND).

Fig.15
The aspect of the model.

Fig.16
Isolation with the rubber dam before cementation. In this case, I decided to cement one by one using Variolink Esthetic DC from Ivoclar.

Fig.17
For this case I chose to use a feldspathic ceramic on refractory die for fabrication of the crowns.

Fig.18
The final aspect of the restorations after one month from the cementation.

Fig.19
The dentis and the patient were very happy with the final aspect.

Conclusions

1. A good impression material gives high precision of the restoration
2. Snap set technology gives a comfortable working time and short setting time combined.

Bibliography

1. Braden, M., Inglis, A.T. Visco elastic properties of dental elasto-meric impression materials. Biomaterials 1986; 7: 45-8.
2. Craig RG and Sun, Z. Trends in elastomeric impression materials. Operative Dent 1994; 138-45.
3. Chee WW and Donovan TE. Polyvinyl siloxane impression ma-terials: a review of properties and techniques. J Prosthet Dent 1992; 68: 728-32.
4. Mandikos MN. Polyvinyl siloxane impression materials: an update on clinical use. Aust Dent J 1998; 43: 428-34.
5. Lee EA. Impression material selection in contemporary ?xed prosthodontics: technique, rationale, and indications. Compend Contin Educ Dent 2005; 26: 780, 782-4, 786-9