Dentaltown August 2020 - 16

show your work
case study

Anterior
Aesthetic Veneers
Bridging the digital-analog divide

by Dr. Jonathan Ferencz
Dr. Jonathan Ferencz graduated from
Rensselaer Polytechnic Institute with a
degree in biology in 1967 and the New
York University College of Dentistry in
1971. He subsequently opened a private
practice in midtown Manhattan and
enrolled in the part-time postgraduate
program in prosthodontics. In 1984, he
established the first honors programs in
prosthodontics for fourth-year students
at NYU. In 1990, Ferencz became clinical professor of postgraduate
prosthodontics, and was certified by the American Board of
Prosthodontics in 1998.
In addition to numerous fellowships, memberships and published
materials, Ferencz is a clinical professor of prosthodontics at
the NYU College of Dentistry, University of Pennsylvania and
the Columbia University School of Dental Medicine. He also is a
consultant for Henry Schein, 3Shape and Ivoclar Vivadent, focused
on dental materials and emerging technologies used in CAD/CAM
and other digital dental applications.

16

The most critical aspect of any highly aesthetic anterior veneer case is
controlling tooth reduction when prepping natural teeth. The goal is to remove a
minimal amount of tooth structure to optimize aesthetics and function while still
providing enough room for the restorative material and optimal bonding strength.
Historically, reduction guide use has been advocated to assist in ensuring adequate
reduction and preventing dentists from under- or overpreparing natural teeth.
In an analog workflow environment, the reduction guide fabrication would
typically start with a traditional impression. The impression would then be sent
to the laboratory with instructions for design and fabrication of a diagnostic
wax-up for patient approval of the final treatment outcome. If the patient approves
the wax-up of the final design, the laboratory creates a putty impression of the
wax-up for the dentist to use as a reduction guide during the tooth preparation
appointment. Should the patient demand changes to the wax-up smile design, the
dentist would communicate those requests to the laboratory and a new diagnostic
wax-up and reduction guide would be created, with associated increased costs,
patient visits and chair time.
Digital technologies have significantly streamlined the workflow and eliminated
the guesswork from the time-intensive analog processes with intraoral scanning
technology and CAD smile design software. However, for veneer cases, the one
missing link in today's digital workflow is the creation and delivery of a reduction
guide that exactly duplicates the digital plan.

AUGUST 2020 // dentaltown.com

DT0820_Ferencz_ShowYourWork_MM.indd 16

7/20/20 2:11 PM


http://www.dentaltown.com

Dentaltown August 2020

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