Dentaltown November 2017 - 33

The following case details a new-generation zirconia that offers strength and
monolithic construction with aesthetic
versatility for the demanding requirements of restorations in the smile zone.
Light transmission closely mimics enamel
through the combination of posterior
zirconia (tetragonal form) with the
cubic form, which provides exceptional
strength (≥800 MPa) and a vital, lifelike appearance. Lastly, a streamlined
protocol for adhesive placement will be
demonstrated to showcase the results.

The case
A 42-year-old female patient came
in with endodontics that had already
been performed on tooth #8. She also
had a substantial amount of restorative
material on teeth #8 and #9. Her chief
complaint was that she did not like
the appearance of her front teeth.
There was significant wear on the
incisal edges and rotations that she
wanted corrected. She simply wanted
a better-looking shape and appearance
for her teeth (Fig. 1).
The preop image demonstrates
the original, triangular shape of the
teeth that the patient wanted altered.
In discussing treatment planning, the
patient gave much consideration to
three facts:
1. Endodontics had already rendered the teeth non-vital (reducing
the importance of being minimally
invasive).
2. The teeth were significantly
composed of restorative material from
prior dental procedures.
3. Modern restorative materials
have gotten better at mimicking natural
tooth structure in the smile zone and
her fear of fake-tooth appearance could
be avoided.
These factors made it easy for the
patient to accept a treatment plan for
crowns.

Fig. 2. Determining shade match

Finding the balance
One of the most challenging things
for dentists has been to balance aesthetics with strength in restorations. We
know that restorative materials with
high levels of glass typically produce the
best aesthetic effect, because the glass
allows the material to mimic enamel.
However, higher glass content leads
to a lower accompanying strength.
There are times when strength takes
precedence, but finding balance with
simple solutions should be the stated
goal. Current zirconia in its tetragonal
form is highly popular for posterior
applications due to chip and fracture
resistance, full-contour simplicity and
ability to be cemented conventionally
or adhesively bonded.
Once sintered, zirconia converts
to a tetragonal form that is highly
resistant to fracture. If a crack develops,
the crystalline nature of the tetragonal
material transforms to a monoclinic
structure and exerts pressure on the
crack to stop it from progressing. This
property gives it a high flexural strength
and better fracture toughness compared
to other dental ceramics. However,
this strength comes with compromises
because the tetragonal form scatters

Fig. 3. Minimal preparations were required for using
3M Lava Esthetic

Fig. 4. Minimal preparations were required for using 3M
Lava Esthetic

Fig. 5. Temporary material reshaped the geometries of the
patient's anterior teeth

dentaltown.com \\ NOVEMBER 2017

33


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Table of Contents for the Digital Edition of Dentaltown November 2017

Dentaltown November 2017 - Intro
Dentaltown November 2017 - Cover1
Dentaltown November 2017 - Cover2
Dentaltown November 2017 - 1
Dentaltown November 2017 - 2
Dentaltown November 2017 - 3
Dentaltown November 2017 - 4
Dentaltown November 2017 - 5
Dentaltown November 2017 - 6
Dentaltown November 2017 - 7
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