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Voilá veneers

Fabricating highly esthetic minimally prepped veneers using IPS e.max Press HT.

By Eddie Corrales, Downtown Dental Designs, San Diego, Calif. Dentistry by Dr. David Eshom, AACD-accredited practice, La Jolla, Calif. Information provided by Ivoclar Vivadent Inc.

Dentists and laboratory technicians today require materials that offer outstanding esthetics, high strength, and efficient productivity. Lithium disilicate glass ceramic combined with pressing technology satisfies these requirements.

For the dentist, lithium disilicate is a highly esthetic, high-strength material that can be conventionally cemented or adhesively bonded and used in all areas of the mouth when specific considerations are taken into account.

For laboratory ceramists, the versatility and performance of lithium disilicate enables them to optimize their productivity when fabricating restorations using the lost-wax pressing fabrication technique.

Overall, these materials demonstrate specific advantages to dentists and patients, including higher edge strength versus traditional glass ceramic materials. This allows the restorations to be finished thinner without chipping. The low viscosity of the heated ingot enables pressing to very thin dimensions, thus allowing the fabrication of minimal-prep or no-prep veneers, and the material exhibits a chameleon effect due to its higher translucency.

Following are step-by-step instructions for using IPS e.max Press HT to fabricate minimally prepped veneers.

The patient presented with misshapen and discolored anterior dentition that she wanted to correct (Fig. A). The treatment plan called for the placement of eight minimally prepped veneers to correct her smile. However, Corrales fabricated 10 veneers to cover the six anterior teeth plus the two premolars for free to improve the case.

THE TECHNIQUE IN PICTURES: SLIDESHOW
(refer to slideshow for figures)

01 The dentist prepped the eight anterior teeth for IPS e.max HT minimally prepped veneers and checked to ensure the proper shade of the final restorations (Fig. B).

02 A stick bite was taken to ensure proper horizontal position of the cast (Fig. C).

03 Provisionals were fabricated from the diagnostic waxup and tried in (Fig. D).

04 A picture of the patient with the provisionals in place was taken to ensure patient approval (Fig. E).

05 A full-contour waxup of the case was fabricated (Fig. F).

06 An incisal edge was formed using Siltek matrix to aid in cutting back the incisal one-third of the waxed patterns before pressing (Fig. G).

07 The wax patterns were sprued and invested, then pressed with IPS e.max Press HT ingots. The pressed restorations were fit to the master model and checked against the Siltek incisal matrix to verify proper reduction for layering of the enamels (Fig. H).

08 Impulse OE4 powders and mix and MM1 and Neutral were applied in a 1:1 ratio to complete incisal characterization (Fig. I).

09 Next, enamel powders TI1, BLI, and OE1 were applied (Fig. J).

10 The final restorations were seated back on the master model (Fig. K).

11 Fig. L shows the translucency effect created on the incisal edge.

12 Figs. M and N show the final restorations post-op.

Added value
Providing the clinician with value-added service by fabricating two additional veneers not only improved the final result of this case but also strengthened the relationship between the dentist and patient, and between the dentist and laboratory.

IPS e.max Press HT
	Features Biocompatible lithium disilicate glass ceramic Offers exceptional fit, form, function, and flexural strength (400 MPa) Kind to opposing dentition Offered in low, medium, and high opacities to meet clinical needs Lifelike esthetics independent of prepared tooth shade Allows conventional or adhesive cementation
Ivoclar Vivadent Inc. 175 Pineview Drive Amherst, NY 14228 800-533-6825	Canada 2785 Skymark Ave. Mississauga, ON L4W 4Y3 800-263-8182

Ivoclar Vivadent
www.ivoclarvivadent.com
info@ivoclarvivadent.com