Dentaltown August 2020 - 17

show your work

case study

The risks of working in the aesthetic
zone without a reduction guide are either
under- or overprepping the natural teeth. If
the teeth are underprepared, the final veneers
will be overcontoured to hide underlying
stump shades. If the teeth are overprepared
and enamel removed, the veneers' bond
strength may be significantly compromised.
In either case, the provisionals and fi nal
restorations may not accurately match the
digital diagnostic wax-up and the dentist
risks patient rejection of the final restorations,
resulting in a remake.
In this case of a 70-year-old patient,
who presented with a diastema and failed
composite restorations to correct excessive
tooth wear and incisal chipping on teeth
#8 and #9 (Figs. 1 and 2), we overcame the
limitations of the digital workflow process
and created a reduction guide that resulted
in provisional and final veneer restorations
that duplicated the approved digital smile
design.

Fig. 1: Retracted view of the patient's preexisting condition,
showing considerable wear to teeth #8 and #9.

Fig. 2: Close-up of the teeth to be restored.

Aesthetic consultation
Intraoral scanners eliminate the need for
physical impressions and the inaccuracies
inherent in the handling and processing of
impression material. The digital impression
scan is uploaded to the dental laboratory and
used in conjunction with CAD software to
create a virtual digital diagnostic wax-up of
the proposed case outcome.
In the case presented here, a retracted
scan of the patient's preoperative condition
was taken (Fig. 3), sent to the laboratory
and uploaded into CAD software (Fig. 4)
for a diagnostic wax-up of the proposed
fi nal case outcome. Within minutes, the
technician proposed two solutions for the
patient to view on-screen. One solution
proposed lengthening her teeth slightly
and fabricating veneers that would close
the diastema. The second solution proposed
keeping the diastema and repairing her
two anterior centrals with highly aesthetic
veneers (Fig. 5). After viewing the virtual

Fig. 3: Scan of pretreatment condition
uploaded to CAD software.

Fig. 4: The maxillary scan is articulated
with the mandibular scan to allow the
technician to do a digital design.

Fig. 5: Preview of virtual digital design shown to
patient on-screen. The design is superimposed
over the original condition to enable the patient to
visualize the anticipated change in tooth contour.

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Dentaltown August 2020

Table of Contents for the Digital Edition of Dentaltown August 2020

Dentaltown August 2020 - Cover1
Dentaltown August 2020 - Cover2
Dentaltown August 2020 - 1
Dentaltown August 2020 - 2
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