Page 28 - Dental Practice Vol 17 No.5_

cosmetic section

WORKFLOW FOR PREDICTABILITY:

INDIRECT COSMETIC REHABILITATION

DR MANAV KALRA AND MOHIT SURYAVANSHI CDT

CLINICAL PERSPECTIVE alizations of the intended changes but also allows for more precise
Contemporary dental practices must now be able to deliver highly aes- tooth preparations. All this now comes together at the end to give us
thetic results with minimal trauma to the tissues. What makes aesthet- results which very closely resemble our initial treatment plan all the
ic dentistry uniquely challenging is that while successful outcomes in while being minimally invasive.
almost all dental procedures have objective measures, the criteria of
success in aesthetic dentistry are largely subjective. We all have differ- LABORATORY PERSPECTIVE
ent concepts of what we think is beautiful and these concepts can vast- A ceramist needs to possess a well-developed skilled perception to
ly differ, even within a given community or culture. visualize and utilize the common elements found in aesthetic, natural
This highlights the importance of effective communication between teeth as well as to successfully replicate the contours of a diagnostic
all parties involved, the patient, the clinician, and the technician. wax-up or a castof the patient-accepted provisional. The ultimate goal
In this particular case, we see the following is to give technicians a methodical contouring procedure that can eas-
• The patient has had composite veneering done on 11,12,21,21. ily be repeated fromcase to case to ensure consistent, predictable, and
• There are diastemas present in the anterior segment life-like aestheticdental restorations. The elements—material, shape,
• Tooth angulations are not ideal (flaring to the distal) light and colour—and their interference which resultsin its perfection
• Loss of canine dominance due to bulky veneering on anterior 4 in aesthetics and natural harmony must be considered as unique and
teeth inseparable. If we want to imitate the light optical phenomena of nat-
Such complex cases can be made more predictable by having the ural teeth,we need materials which do possess the dynamics of light as
technician on board even before the case has started. Photographs and we find it in natural teeth. The specific characteristics of artificial teeth
preoperative models are shared, a detailed conversation ensues and an for various age-groups will be discussed here andconcepts and meth-
aesthetic waxup is produced. We see that all the above-mentioned ods will be presented which show what is necessary to create an aes-
points are taken into account in the waxup itself. The Canine domi- thetic and functional optimised piece of work.
nance is restored all the while correcting the angulations and closing
gaps. This ability to visualise the result gives great confidence to the Article Citation
patient, but more importantly to the dentist. Very often our confi- Kalra, M. Suryavanshi, M. (2021) Workflow for
dence in the procedure is all that is needed for our patients to feel at predictability:Indirect cosmetic rehabilitation. Dental Practice,
ease. It simply is the best method to improve case acceptability, pre- 17(5), 28-34
dictability, and confidence in the treatment. It not only allows for visu-

FIG 1 FIG 2

FIG 3 FIG 4

28 Dental Practice // May-June 2021 // Vol 17 No 5