Dental Asia March/April 2019

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Behind the Scenes angles due to the labial placement of the teeth in the motivational mock-up. Failure to only show the two-dimensional facial photograph will result in the patient losing confidence in the treatment and feeling their teeth “are sticking out”. This is still an essential part of the treatment as it is the only stage in a reductive case where you are able to show the patient a live cosmetic smile trial without performing an irreversible procedure (Fig. 15). Fig. 15 Ideal mock-up Following the sign-off of the additive mock-up by the patient an ideal mockup was created. This was done in the laboratory using 3Shape Dental Design. The existing additive mock-up was repositioned palatally in the correct position of the final restorations. The new final tooth position model was 3D printed and a preparation guide was made to ensure exact reduction for minimal thickness lithium disilicate veneers. This model is also used to make the key for the temporary veneers (Figs. 16-18). Fig. 18 Veneer removal, tooth preparation and temporisation Following anaesthetic administration, the existing veneers were removed using a diamond bur and handpiece. After assessment, the existing porcelain and resin was removed and the ideal mock-up putty key was checked for a passive seat and filled with Expertemp (Ultradent). The key was then removed following curing and the final position of the veneers assessed. Next, 0.5mm was removed in the A, B and C planes through the Expertemp to ensure minimal thickness of the glass ceramic. Particular attention must be paid to the C plane to ensure adequate reduction in the incisal area preventing flaring of the final restorations. The remaining Expertemp was then removed (Fig. 19). health which was essential for this patient. Following accurate assessment of the gingivectomy, laser troughing was performed to create a defined margin prior to the 3Shape TRIOS 3 scan. The preparations were then scanned and uploaded to Race Dental using 3Shape Communicate for same day merging with the pre-preparation (ideal mock-up) in the laboratory. The teeth were then temporised using the ideal mock-up putty key and Expertemp (Fig. 20). Fig. 20 CAD and Milling The ideal mock-up and digital 3Shape TRIOS 3 scan were uploaded into 3Shape Dental Design to create the individual CAD files ahead of milling. Using this software integration enables the predictable replication of the design as shown to the patient and the clinician throughout the planning process. This repeatability and predictability showcases the power of a fully digital workflow (Figs. 21-22). Fig. 16 Fig. 17 Fig. 19 Gingivectomy was required on the central and lateral incisors. This was performed at the time of preparation using the Gemini dual wavelength diode laser (Ultradent). The height of the gingivectomy was defined by the gingival position on the ideal mock-up created in the lab, using 3Shape Dental Design. The cutting and cauterising characteristics of the super pulsed diode laser enables precise and predictable gingival removal, preventing the need for second stage surgery. Additionally, the diode laser will disinfect the gingival sulcus and improve tissue Fig. 21 Fig. 22 64 DENTAL ASIA MARCH / APRIL 2019
Behind the Scenes High translucency bleach shade lithium disilicate blocks coupled with consistent tooth reduction provide lifelike aesthetics when milled as a monolithic restoration. Utilising monolithic restorations also maintains the maximum strength of the material and reduces the introduction of errors in the design through an optional layering process (Figs. 23-24). The 10 veneers were milled by Race Dental using Roland DWX-4W Wet Dental mills. The advanced technology within Race Dental creates a flawless fit making it easier for their technicians to accomplish a perfect and predictable cosmetic result (Fig. 25-26). anaesthetised and the temporary veneers removed. The veneers were checked for fit and aesthetics using shade B0.5 3M Veneer try-in paste. The patient was given an opportunity to assess their final veneers prior to cementation; however this is difficult due the anaesthetic and demonstrates the importance of the very specific digital planning regime outlined above (Fig. 27). Fig. 25 Fig. 23 Fig. 24 Fig. 26 Following manufacture and delivery of the milled restorations the patient was again Fig. 27 Following assessment of the fit and aesthetics of the restorations, the veneers were removed, and a decision was made to cement all 10 veneers simultaneously. The veneers were etched with hydrofluoric acid; cleaned, dried HIGH-PERFORMANCE ROTATING INSTRUMENTS SIMPLIFYING DENTAL MOTION Visit us at Hall 11.2 Booth Q34 TeKne Dental srl – Italy info@teknedental.com www.teknedental.com MARCH / APRIL 2019 DENTAL ASIA 65
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CONTENTS MARCH / APRIL 2019 18 24 2
Page 6:
First Words The New Age of Digitali
Page 10 and 11:
Dental Updates New VOCO Prophylaxis
Page 12:
Dental Updates AACD Welcomes 2019 C
Page 15 and 16: Periodontal Disease Bacteria Linked
Page 18 and 19: Dental Updates Henry Schein One Acq
Page 20 and 21: Under the Spotlight 18 DENTAL ASIA
Page 22 and 23: Under the Spotlight It is easy for
Page 24 and 25: Word of Mouth by Dr. Christoper Ho
Page 26 and 27: CELEBRATING DIGITAL TRANSFORMATION
Page 28 and 29: Dental Profile achieve very good re
Page 31 and 32: Dental Profile TAKING DIGITAL IMPRE
Page 33 and 34: Dental Profile The high-precision S
Page 35 and 36: Dental Profile MARCH / APRIL 2019 D
Page 37 and 38: Clinical Feature The importance of
Page 39 and 40: Fig. 8: X-ray after extraction show
Page 42 and 43: Clinical Feature Glass Ionomer Seal
Page 44 and 45: Clinical Feature Fig. 1.1: An erupt
Page 46 and 47: Clinical Feature 7 TH GENERATION AD
Page 48 and 49: Clinical Feature 1. Decay is noted
Page 50 and 51: User Report CENTION N: REDEFINING D
Page 53 and 54: User Report Amalgam GIC Cention N P
Page 56: User Report Fig. 15: Teeth 46 and 4
Page 59 and 60: User Report initial drilling channe
Page 61 and 62: User Report Fig. 16: Postoperative
Page 64 and 65: Behind the Scenes REPLACEMENT OF EX
Page 68 and 69: Behind the Scenes and silanated for
Page 70 and 71: Behind the Scenes A JOURNEY THROUGH
Page 72 and 73: Behind the Scenes Fig. 11 Fig. 15 r
Page 74 and 75: Behind the Scenes The overall aesth
Page 77 and 78: In Depth With Fig. 1: Primescan - t
Page 79 and 80: In Depth With The blue light used b
Page 81: In Depth With The first set of data
Page 85 and 86: In Depth With Extending Dental Oper
Page 87 and 88: In Depth With combines the cutting-
Page 89 and 90: Product Highlight BRAVIA ® XL Spec
Page 91 and 92: Product Highlight COLTENE Unveils t
Page 93 and 94: Product Highlight 3Shape launches T
Page 96 and 97: Show Preview 9 th -12 th June 2019
Page 98 and 99: Giving Back to Society February is
Page 102: Advertisers’ Index Advertisers Pa
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Dental Asia March/April 2019

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