Dentaltown January 2016 - (Page 57)

general practice column Veneers Utilizing Silicon Matrices to Optimize Ideal Preparation Design by David Hornbrook, DDS, FAACD, FACE Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Simplifying and providing predictability at your smile-design appointment As the clinical director of education at Keating Dental Arts, I am asked often by our dentists how to best take control of the veneer preparation appointment to ensure optimal results. With this in mind, I have created a series of matrices that will simplify this very important, and often times, confusing appointment with your patient. When preparing natural teeth, the goal should be to remove a minimal amount of tooth structure while optimizing esthetics and function, all the while providing adequate room for the restorative material. The first step in a successful esthetic result is the initial smile-design visit. At this appointment, the clinician evaluates the deficiencies of the patient's smile and determines key elements, such as incisal edge position, smile line, incisal edge inclination, midline, profi le, and buccal corridor. This information should then be transferred to the diagnostic esthetic waxer so that an aesthetic and functional wax-up can be designed (Figs. 1-3). The goal of the kit is to provide a set of matrices to act as prep guides to ensure that you do not under prep or over prep. This kit includes an esthetically Fig. 6 designed wax-up, a stone duplicate of the wax-up, a modelplasty model marked by the waxer, a clear, thin, plastic suck-down stint of the wax-up, two preparation silicone matrices, and a silicone matrix of the wax-up to be used to fabricate beautiful provisionals easily and predictably (Fig. 4). The facial and lingual matrices are used as clearance guides. One is for the buccal or facial surfaces, and the other is for the lingual surfaces (Figs. 5 & 6). The final item that is made is a clear plastic matrix. This is used to match any tissue changes in the mouth that may have been made on the model during the wax-up to improve symmetry and esthetics. This clear matrix can also be used to ensure adequate reduction (Figs. 7 & 8, see p. 58). The diagnostic or esthetic waxer will send you a model of the areas that had to be modified prior to beginning the wax-up (Figs. 9 & 10, see p. 58). Usually these areas are marked in black. I call this modelplasty. Any areas where the teeth are misaligned or over-contoured to meet the esthetic and functional desires will need to be modified prior to beginning the wax-up. Using this model where changes are made, reproduce this in the mouth (Figs. 11-13, see p. 58). I prefer to use a fine-tip Sharpie felt pen to mark areas on the teeth to match the reduced model. If the enameloplasty exposes dentin, anesthesia will be required. If the tissue levels were modified by the waxer, this can be evaluated and marked using the clear matrix (Fig. 14, see p. 58). A diode laser can be used to modify the gingival contours to match the wax-up (Fig. 15). After the enameloplasty is performed, in the facial and lingual/incisal dentaltown.com \\ JANUARY 2016 57 http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown January 2016

On Dentaltown.com
HOWARD SPEAKS: What Do You Need in 2016? Another Operatory
PROFESSIONAL COURTESY: The Next Generation of Dentists
Continuing Education Update
Mom Wants to Sit in the Hallway So She Can Hear What We’re Doing to Her Child
Why You Should Never Let Patients Talk You Out of Periodontal Plastic Surgery Before Esthetic Treatment
Chasing Pain: Diagnosing and Treating Trigeminal Neuralgia in General Dentistry
Chasing Sheep: The Four Pillars of Treating the Sleep-Disordered Patient
Product Profi le: Family Dental Marketing
Implementing Orthodontics in Your General Practice
Endodontic Advancements: How Leading Technologies Help Transform Endodontic Treatment Options
The Power of Piezo: A Predictable and Painless Approach
Veneers: Utilizing Silicon Matrices to Optimize Ideal Preparation Design
Improve Your Patients’ Lives Through Pro-Bono Referrals
Progressive Smile Design: Changing the Shape of Cosmetic Dentistry
The Ultimate Handover in Your Dental Office
Meet the New Intraoral Sensor
Poll
Want to Compete with Big Business? Tap Into Your Relationships
Saving Her Smile: Immediate Implant Placement and Fixed Provisionalization with Extracted Tooth
TOWNIE MEETING 2016 Preview
Ad Index
The Heart of the Hygienist: Dental Hygiene’s Role in Public Health
What to Do With Patients Who Refuse SRP and Only Want a Cleaning
CONTINUING EDUCATION: Indirect Posterior Composite Restorations
Dentally Incorrect

Dentaltown January 2016