A clinical case by our Community member Dr. Stefano Conti
This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.
A 20 years old patient came to the clinic with two fractured ceramic crowns on his upper central incisors.
Fig.1
As a treatment, we planned to prepare the teeth to receive two new zirconia crowns on 11-21 and two veneers on 12 and 22 in order to restore the esthetics of a pleasant smile, and a healthy gingival architecture.
Fig.2
As a first step, smile design was performed to evaluate dimension, shape, and position of central and lateral incisors.
Fig.3
Old ceramic crowns were removed.
Fig.4
A chamfer tooth preparation was chosen for teeth 11 and 21, while a direct mock-up was performed at teeth 12, 22.
Fig.5
Temporary crowns and mock-up at the end of the session.
Fig.6
Smile close-up with temporary crowns on 11 and 21, and direct mock-up of 12 and 22.
Fig.7
A Geller cast model was fabricated. CDT Franco Pozzi & Ateicos Quintavalla.
Fig.8
Dental cast ready for the fabrication of the Zirconia crowns according to the wax-up.
Fig.9
Digital superimposition showing wax-up on model.
Fig.10
Final picture shows the final zirconia crown restorations on 11 and 21, and the veneers cemented on 12 and 22.
Fig.11
Lateral view.
Fig.12
Before and after.
Conclusions
Our patient want a natural look, but also strong and durable restorations. The two central incisors were restored with layered zirconia single crown, while the lateral incisors were restored with ceramic veneers.
Relative to anterior teeth, my preference continues to be layered zirconia, while in the posterior monolithic zirconia is still the best option. With layered zirconia and, a thin layering in the buccal area, a 3-dimensional color can be created and optimal esthetic outcomes can be achieved.
Acknowledgements
Lab. Pozzi Franco, Parma,Italy.
Bibliography
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2. Guess PC, Schultheis S, Bonfante EA, Coelho PG, Ferencz JL, Silva NR. All-ceramic systems: laboratory and clinical performance. Dent Clin North Am. 2011 Apr;55(2):333-52, ix.
3. Koenig V, Vanheusden AJ, Le Goff SO, Mainjot AK. Clinical risk factors related to failures with zirconia-based restorations: an up to 9-year retrospective study. J Dent, 41 (2013), pp. 1164-1174
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