Page 54 - DP Vol 19 No 6 pw_Neat

cosmetic section

Press the esthetics button:

Veneer restorations in the

digital workflow

Mahmoud Ezzat Ghazi

TrEaTMEnT concEPT wiTh diGiTal sMilE dEsiGn
and PolychroMaTic hybrid cEraMic
The number of patients seeking to achieve the optimal smile through
veneer treatment continues to grow. For these types of cosmetic
procedures, laboratories and dental practices have always required
materials with a natural play of light and shade that facilitate thin
layers for minimally-invasive treatments. The VITA ENAMIC
multiColor hybrid ceramic with its integrated shade and translucency
gradients now offers the possibility of highly esthetic and incredibly
efficient CAD/CAM restorations – without any firing. 1 The robust
dual network 2 , compromised of a porous pre-sintered and polymer-
infiltrated feldspar ceramic 3 , that enables layers of up to 0.2 millimeters
5
in thickness 4 , with perfectly precise edge areas. In combination with
digital smile design (DSD), the treatment result is predictable and
can be developed together with the patient. In this case study, Dr.
Mahmoud Ezzat Ghazi (Cairo, Egypt) presents the digital and manual Fig 1: The initial situation with a gummy smile and short incisors in the
steps required in the laboratory and dental practice for successful esthetic zone.
restorations in the esthetic zone using this combination.

brown and whiTE sPoTs
A patient presented to the dental practice because she was unhappy
with the esthetic appearance of her smile. During the initial clinical
review, brown and white spots were visible on the vestibular surfaces
of her anterior teeth. The initial caries lesions were the result of
orthodontic treatment with a fixed appliance. When the patient
smiled, a gummy smile and hypertrophy of the gingiva of the upper
incisors was evident. To start, photographic and video documentation
was prepared in order to facilitate a digital record of the initial
situation. The problematic aspects were discussed in detail and
analyzed with the patient. Finally, the initial situation was digitalized
prior to preparation using a 3Shape TRIOS intraoral scanner (3Shape, Fig 2: Generally, the contour of the incisal edges already ran along the
Copenhagen, Denmark). curve of the lips.

1 Steinbrenner H. Multichromatic and highly translucent hybrid ceramic Vita Enamic. Int J Comput Dent 2018; 21(3): 239-250.
2 Coldea A, Swain MV, Thiel N. In-vitro strength degradation of dental ceramics and novel PICN material by sharp indentation. J Mech Behav Biomed
Mater 2013 Oct; 26: 34-42.
3 Coldea A, Swain MV, Thiel N. Mechanical properties of polymer-infiltrated-ceramic-network materials. Dent Mater 2013 Apr; 29(4): 419-26.
4 Dirxen C, Blunck U, Preissner S. Clinical performance of a new biomimetic double network material. Open Dent J 2013 Sep 6; 7: 118-22.
5 Azarbal A, Azarbal M, Engelmeier RL, Kunkel TC. Marginal Fit Comparison of CAD/CAM Crowns Milled from Two Different Materials. J Prosthodont
2018 Jun; 27(5): 421-428.
54 Dental Practice i November-December 2023 i Vol 19 No 6