Patient-centered dentistry - before and after
August 19, 2020
Dr. Walter Devoto, DDS

Clinical Case: An Economic Prosthodontic Approach

Patient-centered dentistry using modern zirconia materials.

About the Case

Hand-veneered zirconia or glass ceramic restorations are still the most beautiful, nature-like treatment option available for many teeth in the anterior region. However, with significant time and effort needed to produce those types of high-end restorations, they are affordable only for a small group of patients. Many others desire more economic approaches that still lead to highly esthetic results.
 
Thanks to modern zirconia materials with a high translucency, natural shade gradient and built-in fluorescence, it is now possible to fulfill the expectations of cost-conscious patients with monolithic restorations. This patient case is a vivid example.

Metal-ceramic crowns on maxillary lateral incisors

INITIAL SITUATION: This patient asked for a replacement of the two metal-ceramic crowns on his maxillary lateral incisors.

Existing crowns were removed

Following shade determination, the existing crowns were removed, revealing tooth abutments with composite build-ups.

Computer-aided design of the monolithic crowns

Computer-aided design of the monolithic crowns.

After sintering, a fine-grain rubber instrument is used

Crown made of translucent fluorescent and gradient-shaded monolithic zirconia. After sintering, a fine-grain rubber instrument is used.

Low-temperature stains are applied

Low-temperature stains are applied to increase the chroma and value effects in the enamel of the restoration.

Polishing with a polishing brush and diamond polishing paste

Polishing with a polishing brush and diamond polishing paste. This leads to a smooth, natural look and is crucial to minimize the wear of the antagonist.

Master cast with two beautifully shaped and colored crowns

Master cast with two beautifully shaped and colored crowns in the position of the lateral incisors.

Try-in of the crown on the right lateral incisor

Try-in of the crown on the right lateral incisor. The color of the crown matches the optical properties of the adjacent teeth very well.

Preparations for cementation

Preparations for cementation: use of retraction paste for tissue management.

Tooth abutment after complete removal of the paste

Tooth abutment after complete removal of the paste by rinsing with water.

Checking the shade match and natural color gradient

Checking the shade match and natural color gradient with the aid of a polishing filter.

Two monolithic zirconia crowns in place

FINAL SITUATION: The two monolithic zirconia crowns in place.

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