The art of keeping it simple

A female patient with a old zirconia crown on the tooth 11 and a large composite restoration on the tooth 11 came to our University Egas Moniz in Portugal (International Certification in Adhesive and Aesthetic Restorative Dentistry) to improve the aesthetic on that teeth.
After the extra-oral and intra-oral examination and treatment planning done was planed a new zirconia crown for the tooth 11 and a ceramic veneer for the tooth 11.

Fig.1

The patient present a old zirconia crown and a large defective composite restoration on the tooth 21.

Fig.2

Initial situation.

Fig.3

Wax-up model.

Fig.4

Mock-up with Protemp 4.

Fig.5

Tooth preparations. In the tooth 11 was keep the preparation for a crown and the tooth 21 was prepared for a ceramic veneer, keeping the surface on enamel.

Fig.6

After the silicone impressions of the preparations, the provisional restorations made with Protemp 4 was placed.

Fig.7

Zirconia crown and glass ceramic veneer on the lab work model.

Fig.8

Zirconia crown and glass ceramic veneer on the lab work model.

Fig.9

Glass ceramic veneer of the tooth 21.

Fig.10

Zirconia Crown of the tooth 11.

Fig.11

Zirconia crow and ceramic veneer Try-in.

Fig.12

Teeth isolation for the adhesive cementation.

Fig.13

Try-in of the restorations after rubber dam placement.

Fig.14

Try-in of the restorations after rubber dam placement.

Fig.15

Zirconia crown internal surface preparation: sandblasting with Cojet.

Fig.16

HF 9% application in the internal surface of the glass ceramic veneer.

Fig.17

HF 9% cleaning on the ceramic veneer.

Fig.18

HF 9% cleaning on the ceramic veneer.

Fig.19

Single Bond Plus application in the Zirconia crown internal surface.

Fig.20

Single Bond Plus application in the glass ceramic veneer internal surface.

Fig.21

Tooth preparations cleaning with Cojet.

Fig.22

Application of the phosphoric etching.

Fig.23

Phosphoric etching cleaning with water.

Fig.24

Scotchbond Universal Plus.

Fig.25

Scotchbond Universal Plus application.

Fig.26

Scotchbond Universal Plus application.

Fig.27

Scotchbond Universal Plus gentle solvent evaporation.

3M resin and adhesive style italiano styleitaliano
3M resin and adhesive style italiano styleitaliano

Fig.28

RelyX Universal Zirconia application on the internal surface.

Fig.29

RelyX Universal application in the internal surface of the glass ceramic veneer.

Fig.30

Light curing 20 seconds from each side with Elipar Deep Cure.

Fig.31

ReleyX Universal cement excess removal.

Fig.32

Immediately final situation after cementation.

Fig.33

Final situation with one week follow-up.

Fig.34

Final situation with two months follow-up.

Conclusions

In this case was used the new Scotchbond Universal Plus and the new RelyX Universal. This resin cement can be applied in different adhesive strategies and with different restorative materials.
Using a universal cementation strategy, as a single adhesive and a single resin cement, shows to be simple and reliable.