Dental Lab Products - April 2009 - (Page 18)

FORWARD Trends \\\\ VENEERS PRESS FOR LESS Keevin Shigenaka, CDT, details the fabrication of no-prep veneers using Prismatik ThinPress leucite-reinforced pressable ceramic from Glidewell Direct (www.glidewelldental.com), the same materials Glidewell Labs uses in its brandname Vivaneers ultra-thin veneers. 1 2 3 THE FEE REMAINS THE SAME PHOTOS: GLIDEWELL DENTAL. 63.5% of lab owners do not charge different fees for different types of veneers such as ultra-thin veneers. Source: DLP April 2009 Veneer survey. 4 5 6 1 2 3 4 The patient is an ideal candidate for the no-prep veneers to close a large diastema between teeth #8 and #9 as well as between #5 and #6 (Fig. 1). The master model is prepared, taking special care to blockout any undercuts, the margins are marked, and then die hardener is applied. After applying a thin layer of die lube, the technician hand-waxes to full contour and desired arch alignment, then separates each veneer with an interproximal cut (Fig. 2). 5 6 7 No. 10 gauge sprues cut to 8-mm length are attached to the incisal third of the waxups at a 45° angle (Fig. 3). The facial of the waxed veneers should angle toward the center of the ring with the margins directed outward. 8 9 Final contour is achieved and all areas smoothed with a ﬁne diamond No. 707 (Fig. 4). All surfaces are carefully sandblasted to remove contaminants. The shade of the veneer is waxed on the sprue former, the case is invested, burned, pressed, and divested following manufacturer directions. The veneers are kept wet during sprue removal, then the veneers are checked under magniﬁcation and then on the dies for ﬁt. Any necessary reduction can be done with a porcelain wheel and water dip, any additions to contacts using correction powders during glaze. The stain and glaze powders are mixed with the universal liquid with a composite resin stump stick for shading (Fig. 5). The veneers are allowed to dry for at least 4 minutes, then ﬁred. The wax veneer is checked to ensure a minimum 0.3 mm thickness on labial areas and 0.4 to 0.5 mm on the gingival, mesial, and distal areas. The patient was pleased with the smile enhancement that required no tooth preparation by the clinician (Fig. 6). 10 11 The veneers are etched, then delivered to the dentist. waxes for pressing veneers, newer materials have been introduced to the market that eliminate much of the manual labor and skill necessary to form the tooth. Preformed wax patterns can greatly speed up and regulate the process, while polymer blocks can be custom designed and milled via applicable CAD/CAM systems. Laboratories also can utilize the services of outsourcing services to generate 3D printed wax patterns or purchase the software and hardware for in-house printing if working with a high volume of pressing cases. “What used to be in the hands of a ceramist now is in the hands of a good waxer,” said Miolen. “It’s changing the way lab owners hire and the way they structure their labs.” He added that technicians who can be trained to wax also are easier to employ than ceramists, who have years of training and experience, but who also are retiring and leaving lab owners with a difficult time finding replacements. In addition to veneers, pressable materials can be used to create all-ceramic singleunit inlays, onlays, and anterior crowns as well as multi-unit bridges or posterior crowns with a metal or zirconia substructure (depending on the particular material). is versatility facilitates shade matching of adjacent and opposing restorations. Pressing also a ords nishing options as the technician can simply stain and glaze the pressed full-contour restoration or cutback and layer with compatible porcelain for added esthetics. “If I’m doing multiple units, I just stain and glaze the anterior. But if it’s just one or two units, I will layer because I’m matching natural dentition. If I’m making all the teeth in the anterior, then I can stain and glaze and make everything match,” said Miolen. “That just makes my lab so much more productive and efficient.” THIN IS IN With traditional leucite and feldspathic pressable materials there is a limit to just how thin the veneers could be pressed. e standard 0.6-mm-thick pressed veneer requires the clinician to grind the surface enamel of the tooth, which then requires the use of provisional restorations while the veneers are fabricated in the lab as well as bonding the veneers in place. Around ve years ago, Den-Mat Corp. introduced Lumineers ultra-thin (0.3-mm) pressed feldspathic veneers that require minimal or no prep by the dentist, which at rst caused some concern in the dental profession. “General dentistry frowned on the procedure, and so did Glidewell,” recalled Shigenaka. “If you don’t reduce any tooth structure, you’re adding on. It’s going to be bulky, it’s not healthy, and you’re creating a speed bump down at the gingiva.” However, after numerous cases were placed by Glidewell’s in-house clinician Dr. Michael DiTolla and the endorsement by Dr. Gordon Christensen of Den-mat’s Lumineers ultra-thin veneer and the no-prep technique in general, Shigenaka said Glidewell saw the no-prep veneers as a valuable treatment option and the wave of the future. “ e reward factor for the patient is so great that you realize that you are doing a good service, and you are doing legitimate dentistry,” he said. According to Shigenaka, Glidewell ceramic engineers set out to develop their own pressable ceramic capable of pressing to 0.3 mm for no-prep veneers and eventually came up with a leucite-reinforced feldspathic porcelain that is a variation of a layering ceramic and available in a range of opacities. “ at became our entry into the market,” he said. Like Den-Mat (as do several other labs), Glidewell markets its own Vivaneers brand direct to dentists as a no-prep, non-invasive 18 dentallabproducts April dlpmagazine.com http://www.glidewelldental.com http://www.dlpmagazine.com

Table of Contents Feed for the Digital Edition of Dental Lab Products - April 2009

Dental Lab Products - April 2009 Contents From the Editor Product Watch New Face of Veneers Veneer Venue Chairside Metal Here and Now Seamless Integration Pressing Versatility Pinless Duplication The Fine Art of Delegating City of Big Ideas Spring Forward Industry News Easy Does It Art of Articulation Classifieds The Perfect Storm

Dental Lab Products - April 2009

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